RAAS Inhibitors May Cut Risk for Rupture in Brain Aneurysm


FRIDAY, June 10, 2022 — Among patients with hypertension and intracranial aneurysm, renin-angiotensin-aldosterone system (RAAS) inhibitors may reduce the risk for rupture compared with other classes of antihypertensive drugs, according to a study published online June 3 in Hypertension.

Ping Zhong, from The First Affiliated Hospital of Xiamen University in China, and colleagues analyzed prospectively collected data from 3,044 hypertensive patients with intracranial aneurysms seen at 20 medical centers in China.

The researchers found that rupture risk was independently associated with female sex; passive smoking; uncontrolled, or unmonitored hypertension; use of over two antihypertensive medications; RAAS inhibitor use; antihyperglycemic agent use; hyperlipidemia; ischemic stroke; and aneurysmal location. Compared to use of non-RAAS inhibitors, the use of RAAS inhibitors was significantly associated with a reduced rupture risk (odds ratio, 0.490). Additionally, the use of angiotensin-converting enzyme inhibitors (odds ratio, 0.559) and use of angiotensin receptor blockers (odds ratio, 0.414) were both significantly associated with a reduced rupture risk versus use of non-RAAS inhibitors. Findings persisted even among people with controlled hypertension.

“Based on these data, we estimate that nearly 18 percent of ruptured aneurysms may be prevented if all patients with high blood pressure and intracranial aneurysms were prescribed with RAAS inhibitors,” a coauthor said in a statement. “Due to the strong potential benefit and high safety of RAAS inhibitors, these findings may also help clinicians to optimize treatment to help people with high blood pressure prevent aneurysm rupture.”

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