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Cardiovascular and renal protective role of angiotensin blockade in hypertension with advanced CKD: a subgroup analysis of ATTEMPT-CVD randomized trial.
Kim-Mitsuyama, Shokei; Soejima, Hirofumi; Yasuda, Osamu; Node, Koichi; Jinnouchi, Hideaki; Yamamoto, Eiichiro; Sekigami, Taiji; Ogawa, Hisao; Matsui, Kunihiko.
Afiliación
  • Kim-Mitsuyama S; Department of Pharmacology and Molecular Therapeutics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. mitsuyam@gpo.kumamoto-u.ac.jp.
  • Soejima H; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Yasuda O; Health Care Center, Kumamoto University, Kumamoto, Japan.
  • Node K; Department of Sports and Life Sciences, National Institute of Fitness and Sports in Kanoya, Kanoya, Japan.
  • Jinnouchi H; Department of Cardiovascular Medicine, Saga University, Saga, Japan.
  • Yamamoto E; Diabetes Care Center, Jinnouchi Clinic, Kumamoto, Japan.
  • Sekigami T; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Ogawa H; Division of Internal Medicine & Diabetes and Endocrine, Sekigami Clinic, Yatsushiro, Japan.
  • Matsui K; National Cerebral and Cardiovascular Center, Suita, Japan.
Sci Rep ; 8(1): 3150, 2018 02 16.
Article en En | MEDLINE | ID: mdl-29453374
The ATTEMPT-CVD study was prospective randomized active-controlled trial and the main findings had been reported. According to baseline GFR and albuminuria categories, we divided the patients of the ATTEMPT-CVD study into 2 subgroups: (Group 1) the patients with at least one of eGFR of <45 ml/min per 1.73 m2 and UACR of ≥300 mg/g creatinine, defined as G3b and/or A3; (Group 2) the patients except for Group 1, defined as the other patients. In patients with G3b and/or A3, the incidence of cardiovascular events was significantly less in ARB group than in non-ARB group (11 vs 22, respectively) (HR = 0.465: 95%CI = 0.224-0.965; P = 0.040). UACR was significantly less in ARB group than in non-ARB group during follow-up period in patients with G3b and/or A3 (P = 0.0003), while eGFR, plasma BNP levels, and blood pressure were comparable between ARB and non-ARB groups. Allocation to ARB therapy was a significant independent prognostic factor for cardiovascular events in patients with G3b and/or A3 (P = 0.0268). On the other hand, in the other patients, the occurrence of cardiovascular events was comparable between ARB and non-ARB groups. In patients with advanced CKD, ARB-based therapy may confer greater benefit in prevention of cardiovascular events than non-ARB therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Receptores de Angiotensina / Sistema Cardiovascular / Insuficiencia Renal Crónica / Antagonistas de Receptores de Angiotensina / Hipertensión / Riñón Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Sci Rep Año: 2018 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Receptores de Angiotensina / Sistema Cardiovascular / Insuficiencia Renal Crónica / Antagonistas de Receptores de Angiotensina / Hipertensión / Riñón Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Sci Rep Año: 2018 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido