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Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study

BMJ 2017; 356 doi: (Published 09 March 2017) Cite this as: BMJ 2017;356:j791

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Uncontrolled Confounding Playing Here Again???

Although this study is large and the results looks interesting and intriguing and stratified, not all potential confounders were dealt with--for example, ethnicity.

So, we have to agree with Prof. Sattar that this is not randomised clinical trial evidence (1) but rather only observational evidence.

1. Journal of the American College of Cardiology Volume 66, Issue 11, September 2015. DOI: 10.1016/j.jacc.2015.07.021
Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitor-Based Treatment on Cardiovascular Outcomes in Hypertensive Blacks Versus Whites
Gbenga Ogedegbe, Nirav R. Shah, Christopher Phillips, Keith Goldfeld, Jason Roy, Yu Guo, Joyce Gyamfi, Christopher Torgersen, Louis Capponi, Sripal Bangalore

Competing interests: No competing interests

03 June 2017
Jose Mario F. de Oliveira
Associate Professor of Medicine
Department of Medicine. Universidade Federal Fluminense
Rua Senador Vergueiro " 2 Apt. 202. Rio de Janeiro, 22230-001; Brazil.