Cardiovascular and renal protective role of angiotensin blockade in hypertension with advanced CKD: a subgroup analysis of ATTEMPT-CVD randomized trial.
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| Abstract |
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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| Authors | Shokei Kim-Mitsuyama, Hirofumi Soejima, Osamu Yasuda, Koichi Node, Hideaki Jinnouchi, Eiichiro Yamamoto, Taiji Sekigami, Hisao Ogawa, Kunihiko Matsui |
| Journal | Scientific reports (Sci Rep) Vol. 8 Issue 1 Pg. 3150 (02 16 2018) ISSN: 2045-2322 [Electronic] England |
| PMID | 29453374 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't) |
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