{"id":"4d09ea33ce0e","type":"article","url":"https://hartvaat.nl/2016/11/07/ace-remmer-en-groeisnelheid-van-kleine-abdominale-aorta-aneurysmata-gerandomisee/","title":"ACE-remmer en groeisnelheid van kleine abdominale aorta-aneurysmata: gerandomiseerde trial","title_en":"An evaluation of the effect of an angiotensin-converting enzyme inhibitor on the growth rate of small abdominal aortic aneurysms: a randomized placebo-controlled trial (AARDVARK).","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["ace-remmers","aortainsufficiëntie","fidelio-dkd","figaro-dkd","ramipril","ras-remmers"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehw257","source_url":"https://doi.org/10.1093/eurheartj/ehw257","authors":["Colin D Bicknell","Gaia Kiru","Emanuela Falaschetti","Janet T Powell","Neil R Poulter"],"significance":6,"published":"2016-11-07","source_date":"2016-11-07","image":"","kennis":[],"congress":"","summary_en":"The AARDVARK trial showed that ACE inhibitor therapy does not reduce the growth rate of small abdominal aortic aneurysms, a negative result for pharmacological aneurysm management.","created":"2026-07-03T10:26:24Z","updated":"2026-07-03T13:25:44Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial die het effect van een ACE-remmer onderzocht op de groeisnelheid van kleine abdominale aorta-aneurysmata. Onderzoekt of farmacologische interventie de progressie kan vertragen.","abstract_original":"AIMS: The AARDVARK (Aortic Aneurysmal Regression of Dilation: Value of ACE-Inhibition on RisK) trial investigated whether ACE-inhibition reduces small abdominal aortic aneurysms (AAA) growth rate, independent of blood pressure (BP) lowering. METHODS AND RESULTS: A three-arm, multi-centre, single-blind, and randomized controlled trial (ISRCTN51383267) was conducted in 14 hospitals in England. Subjects aged ≥55 years with AAA diameter 3.0-5.4 cm were randomized 1:1:1 to receive perindopril arginine 10 mg, or amlodipine 5 mg, or placebo and followed 3-6 monthly over 2 years. The primary outcome was aneurysm growth rate (based on external antero-posterior ultrasound measurements in the longitudinal plane), determined by multi-level modelling to provide maximum likelihood estimates. Two hundred and twenty-four subjects were randomized (2011-2013) to placebo (n = 79), perindopril (n = 73), or amlodipine (n = 72). Mean (SD) changes in mid-trial systolic BP (12 months) were 0.5 (14.3) mmHg, P = 0.78 compared with baseline, -9.5 (13.1) mmHg (P < 0.001), and -6.7 (12.0) mmHg (P < 0.001), respectively. No significant differences in the modelled annual growth rates were apparent [1.68 mm (SE 0.2), 1.77 mm (0.2), and 1.81 mm (0.2), respectively]. The estimated difference in annual growth between the perindopril and placebo groups was 0.08 mm (CI -0.50, 0.65). Similar numbers of AAAs in each group reached 5.5 cm diameter and/or underwent elective surgery: 11 receiving placebo, 10 perindopril, and 11 amlodipine. CONCLUSION: Small AAA growth rates were lower than anticipated, but there was no significant impact of perindopril compared with placebo or placebo and amlodipine, combined despite more effective BP lowering."}