Document Detail


Angiotensin receptor blocker-based therapy and cardiovascular events in hypertensive patients with coronary artery disease and impaired renal function.
MedLine Citation:
PMID:  20491606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to assess the effects of angiotensin receptor blocker (ARB)-based therapy on cardiovascular events in high-risk hypertensive patients with coronary artery disease (CAD) and impaired renal function in post hoc analysis of HIJ-CREATE (Heart Institute of Japan Candesartan Randomized Trial for Evaluation in Coronary Artery Disease). Patients (n=2049) were randomly assigned to candesartan-based or non-ARB treatment arms; 1022 patients (age 70 ± 6 years, 28% female) with impaired renal function, defined as creatinine clearance <60 ml/min at baseline. There was no difference in major adverse cardiac event (MACE), a composite of cardiovascular death, non-fatal myocardial infarction, unstable angina, heart failure, stroke and other cardiovascular events requiring hospitalization between the two arms in patients without impaired renal function. However, there was a lower incidence of MACE in the candesartan-based treatment arm than in the non-ARB treatment arm (HR=0.79, 95% CI 0.63-0.99, p=0.039) in patients with impaired renal function. Among the MACE, candesartan-based treatment reduced hospitalization for unstable angina (HR=0.71, 95% CI 0.52-0.96, p=0.028). Although candesartan-based treatment was not superior to non-ARB treatment in prevention of cardiac mortality, ARB-based therapy may be beneficial in reducing risk of coronary events in hypertensive patients with CAD and impaired renal function.
Authors:
Tsuyoshi Shiga; Hiroshi Kasanuki; Nobuhisa Hagiwara; Tetsuya Sumiyoshi; Takashi Honda; Kazuo Haze; Atsushi Takagi; Masatoshi Kawana; Hideki Origasa; Hiroshi Ogawa;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-05-24
Journal Detail:
Title:  Blood pressure     Volume:  19     ISSN:  1651-1999     ISO Abbreviation:  Blood Press.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2011-03-31     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  9301454     Medline TA:  Blood Press     Country:  England    
Other Details:
Languages:  eng     Pagination:  359-65     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. mshiga@hij.twmu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II Type 1 Receptor Blockers / therapeutic use*
Antihypertensive Agents / therapeutic use
Benzimidazoles / therapeutic use*
Coronary Artery Disease / complications*,  drug therapy*
Female
Humans
Hypertension / complications*,  drug therapy*
Kaplan-Meier Estimate
Male
Middle Aged
Prospective Studies
Renal Insufficiency / complications*
Risk Factors
Tetrazoles / therapeutic use*
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Benzimidazoles; 0/Tetrazoles; S8Q36MD2XX/candesartan

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