Use of Angiotensin II Receptor Blockers and the Risk of Acute Pancreatitis: A Nested Case-Control Study

Background: There is no specific treatment aqainst acute pancreatitis (AP). A protective effect by angiotensin II receptor blockers (ARB) on AP has been suggested experimentally, but clinical evidence is scarce. Methods: We conducted a population-based case-control study using The Health Improvement Network in the United Kingdom, comprising about 167,000 hypertensive patients in the study period 1996-2005. In multivariate logistic regression analysis, odds ratios were calculated with 95% confidence intervals (CI). Adjustments included sex, age, calendar year, body mass index, tobacco smoking, alcohol, general practitioner visits per year, and various antihypertensive medications with regard to exposure to ARB, and risk of AP. Results: Among 633,281 person-years at risk, 265 new cases of AP were identified. Current users of ARB had a 37% statistically non-significant reduced risk of developing AP as compared to non-users (OR 0.63, 95% CI Q.38-1.02). No clear association was found between use of other antihypertensive drugs and risk of AP. Conclusion: Our study adds some support to previous experimental findings. Use of ARB might be associated with a reduced risk of AP. More research is needed to elucidate the potential role of ARB in the development of AP in the clinical setting.