# ACE-remmer en groeisnelheid van kleine abdominale aorta-aneurysmata: gerandomiseerde trial

*geplaatst 2016-11-07 · Hypertensie · European heart journal · doi 10.1093/eurheartj/ehw257 · https://hartvaat.nl/2016/11/07/ace-remmer-en-groeisnelheid-van-kleine-abdominale-aorta-aneurysmata-gerandomisee/*

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.

## English: 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).

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.

## Abstract (original, from the publication)

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.

Auteurs: Colin D Bicknell, Gaia Kiru, Emanuela Falaschetti, Janet T Powell, Neil R Poulter

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehw257. Bijgewerkt 2026-07-03T13:25:44Z. 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.