title: Blockers of Angiotensin Other Than Olmesartan in Patients With Villous Atrophy: A Nationwide Case-Control Study.
abstract: OBJECTIVE
  To examine the association between the previous use of nonolmesartan angiotensin receptor blockers (ARBs) or any angiotensin-converting enzyme inhibitor (ACEI) and subsequent villous atrophy (VA) in patients with small-intestinal VA as compared with general population-matched controls.
  
  
  METHODS
  A case-control study was used to link nationwide histopathology data on 2933 individuals with VA (Marsh grade 3) to the Swedish Prescribed Drug Register to examine the association between the use of ACEIs as well as the specific use of ARBs other than olmesartan and subsequent VA. Olmesartan is not available in Sweden, so this exposure was not examined. All individuals with VA had biopsies performed between July 1, 2005, and January 29, 2008, and matched on age, sex, calendar period of birth, and county of residence to 14,571 controls from the general population.
  
  
  RESULTS
  Use of nonolmesartan ARBs was not associated with VA (odds ratio, 0.84; 95% CI, 0.64-1.09; P=.19). Neither was VA associated with a previous medication of any ACEI (odds ratio, 1.08; 95% CI, 0.90-1.30; P=.41). Restricting the analysis to individuals with repeated prescriptions for ACEIs or ARBs revealed only marginally changed risk estimates for VA.
  
  
  CONCLUSIONS
  The lack of association between the use of ACEIs and nonolmesartan ARBs and subsequent VA suggests that these medications are not a major risk factor for the development of VA in the general population.
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden. Electronic address: karlmarild@gmail.com.
authors.forename: Karl
authors.initials: K
authors.lastname: Mårild
authors.affiliation: Celiac Disease Center, Department of Medicine, Columbia University Medical Center, Columbia University, New York, NY.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lebwohl
authors.affiliation: Celiac Disease Center, Department of Medicine, Columbia University Medical Center, Columbia University, New York, NY.
authors.forename: Peter H R
authors.initials: PH
authors.lastname: Green
authors.affiliation: Division of Gastroenterology and Hepatology, Departments of Medicine and Immunology, Mayo Clinic, Rochester, MN.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Murray
authors.affiliation: Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
authors.forename: Jonas F
authors.initials: JF
authors.lastname: Ludvigsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001284:Atrophy / Q000139:chemically induced / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008871:Microvilli / Q000473:pathology*; D008875:Middle Aged; D016017:Odds Ratio; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors