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Member
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Join Date: Jan 2009
Location: Paradise
Posts: 855
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Member
Join Date: Jan 2009
Location: Paradise
Posts: 855
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Quote:
Originally Posted by Mslday
Hi Sandel,
For further consideration here is a link I thought you would find interesting.
The association between ACE inhibitors and the complex regional pain syndrome: Suggestions for a neuro-inflammatory pathogenesis of CRPS
M. de Mosa, F.J.P.M. Huygenb, B.H.Ch. Strickera, J.P. Dielemana, M.C.J.M. Sturkenbooma
Received 15 August 2008; received in revised form 2 December 2008; accepted 23 December 2008. published online 05 February
Abstract
Antihypertensive drugs interact with mediators that are also involved in complex regional pain syndrome (CRPS), such a neuropeptides, adrenergic receptors, and vascular tone modulators. Therefore, we aimed to study the association between the use of antihypertensive drugs and CRPS onset. We conducted a population-based case-control study in the Integrated Primary Care Information (IPCI) database in the Netherlands. Cases were identified from electronic records (1996–2005) and included if they were confirmed during an expert visit (using IASP criteria), or if they had been diagnosed by a medical specialist. Up to four controls per cases were selected, matched on gender, age, calendar time, and injury. Exposure to angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists, β-blockers, calcium channel blockers, and diuretics was assessed from the automated prescription records. Data were analyzed using multivariate conditional logistic regression. A total of 186 cases were matched to 697 controls (102 confirmed during an expert visit plus 84 with a specialist diagnosis). Current use of ACE inhibitors was associated with an increased risk of CRPS (ORadjusted: 2.7, 95% CI: 1.1–6.8). The association was stronger if ACE inhibitors were used for a longer time period (ORadjusted: 3.0, 95% CI: 1.1–8.1) and in higher dosages (ORadjusted: 4.3, 95% CI: 1.4–13.7). None of the other antihypertensive drug classes was significantly associated with CRPS. We conclude that ACE inhibitor use is associated with CRPS onset and hypothesize that ACE inhibitors influence the neuro-inflammatory mechanisms that underlie CRPS by their interaction with the catabolism of substance P and bradykinin.
http://www.painjournalonline.com/art...768-9/abstract
MsL |
Sounds good in theory and maybe it is so. The only problem I have is this:
CRPS/RSD affects something like 9:1 women to men or so, right? Hypertension, the main indication for ACE inhibitors, runs in a ratio of close to 2:1 men to women. So therefore, most of the people that acquire CRPS/RSD are women, for which few (compared to men) are taking ACE inhibitors by virtue of men suffering from HTN at a significantly increased incidence.
So....since more men have HTN and are likely taking ACE inhibitors than women, why do women have RSD/CRPS at a 9:1 ratio compared to men???
Must be a confounding variable thing...
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