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Apolipoprotein E and Progression of Chronic Kidney Disease—Reply
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In Reply: Dr Kida suggests that the use of ACE inhibitors or ARBs may confound the association between APOE genotype and chronic kidney disease progression. Use of antihypertensive medication had been adjusted for in our multivariate Cox models and did not modify the association between APOE and chronic kidney disease progression, which is the expected result given that antihypertensive medication use should not be associated with APOE genotype.
Detailed data on ARB use were not collected in the ARIC (Atherosclerosis Risk in Communities) study because visits were conducted from 1989-1999, mostly before losartan and other ARBs became widely available.1-2 However, data on ACE inhibitor use were collected. Over the 4 ARIC visits, the proportion of participants using ACE inhibitors increased both among individuals with hypertension (visit 1 [7.9%], visit 2 [15.7%], visit 3 [19.7%], and visit 4 [23.3%]) and among all participants (visit 1 [3.0%], visit 2 [5.8%], visit 3 . . . [Full Text of this Article]
Charles C. Hsu, PhD;
Josef Coresh, MD, PhD
coresh@jhu.edu
W. H. Linda Kao, PhD
Department of Epidemiology
The Johns Hopkins Medical Institutions
Baltimore, Md
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