No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients

Christian D Peters; Krista D Kjaergaard; Jens D Jensen; Kent L Christensen; Charlotte Strandhave; Ida N Tietze; Marija K Novosel; Bo M Bibby; Lars T Jensen; Erik Sloth; Bente Jespersen

doi:10.1038/ki.2014.69

No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients

Christian D Peters, Krista D Kjaergaard, Jens D Jensen, Kent L Christensen, Charlotte Strandhave, Ida N Tietze, Marija K Novosel, Bo M Bibby, Lars T Jensen, Erik Sloth, Bente Jespersen

Department of Clinical Medicine

32 Citations (Scopus)

Abstract

Agents blocking the renin-angiotensin-aldosterone system are frequently used in patients with end-stage renal disease, but whether they exert beneficial cardiovascular effects is unclear. Here the long-term effects of the angiotensin II receptor blocker, irbesartan, were studied in hemodialysis patients in a double-blind randomized placebo-controlled 1-year intervention trial using a predefined systolic blood pressure target of 140 mm Hg (SAFIR study). Each group of 41 patients did not differ in terms of age, blood pressure, comorbidity, antihypertensive treatment, dialysis parameters, and residual renal function. Brachial blood pressure decreased significantly in both groups, but there was no significant difference between placebo and irbesartan. Use of additional antihypertensive medication, ultrafiltration volume, and dialysis dosage were not different. Intermediate cardiovascular end points such as central aortic blood pressure, carotid-femoral pulse wave velocity, left ventricular mass index, N-terminal brain natriuretic prohormone, heart rate variability, and plasma catecholamines were not significantly affected by irbesartan treatment. Changes in systolic blood pressure during the study period significantly correlated with changes in both left ventricular mass and arterial stiffness. Thus, significant effects of irbesartan on intermediate cardiovascular end points beyond blood pressure reduction were absent in hemodialysis patients.

Original language	English
Journal	Kidney International
Volume	86
Issue number	3
Pages (from-to)	625-37
ISSN	0085-2538
DOIs	https://doi.org/10.1038/ki.2014.69
Publication status	Published - Sept 2014

Keywords

Adult
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers
Arterial Pressure
Biphenyl Compounds
Catecholamines
Double-Blind Method
Female
Heart Rate
Heart Ventricles
Humans
Hypertension
Kidney Failure, Chronic
Male
Middle Aged
Natriuretic Peptide, Brain
Organ Size
Peptide Fragments
Pulse Wave Analysis
Renal Dialysis
Tetrazoles
Vascular Stiffness
Journal Article
Randomized Controlled Trial

Access to Document

10.1038/ki.2014.69

http://www.kidney-international.org/article/S0085253815303227/pdf

Cite this

Peters, C. D., Kjaergaard, K. D., Jensen, J. D., Christensen, K. L., Strandhave, C., Tietze, I. N., Novosel, M. K., Bibby, B. M., Jensen, L. T., Sloth, E., & Jespersen, B. (2014). No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients. Kidney International, 86(3), 625-37. https://doi.org/10.1038/ki.2014.69

@article{fb16bb491992497c8bfa3cabac2fe894,

title = "No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients",

abstract = "Agents blocking the renin-angiotensin-aldosterone system are frequently used in patients with end-stage renal disease, but whether they exert beneficial cardiovascular effects is unclear. Here the long-term effects of the angiotensin II receptor blocker, irbesartan, were studied in hemodialysis patients in a double-blind randomized placebo-controlled 1-year intervention trial using a predefined systolic blood pressure target of 140 mm Hg (SAFIR study). Each group of 41 patients did not differ in terms of age, blood pressure, comorbidity, antihypertensive treatment, dialysis parameters, and residual renal function. Brachial blood pressure decreased significantly in both groups, but there was no significant difference between placebo and irbesartan. Use of additional antihypertensive medication, ultrafiltration volume, and dialysis dosage were not different. Intermediate cardiovascular end points such as central aortic blood pressure, carotid-femoral pulse wave velocity, left ventricular mass index, N-terminal brain natriuretic prohormone, heart rate variability, and plasma catecholamines were not significantly affected by irbesartan treatment. Changes in systolic blood pressure during the study period significantly correlated with changes in both left ventricular mass and arterial stiffness. Thus, significant effects of irbesartan on intermediate cardiovascular end points beyond blood pressure reduction were absent in hemodialysis patients.",

keywords = "Adult, Aged, Aged, 80 and over, Angiotensin II Type 1 Receptor Blockers, Arterial Pressure, Biphenyl Compounds, Catecholamines, Double-Blind Method, Female, Heart Rate, Heart Ventricles, Humans, Hypertension, Kidney Failure, Chronic, Male, Middle Aged, Natriuretic Peptide, Brain, Organ Size, Peptide Fragments, Pulse Wave Analysis, Renal Dialysis, Tetrazoles, Vascular Stiffness, Journal Article, Randomized Controlled Trial",

author = "Peters, {Christian D} and Kjaergaard, {Krista D} and Jensen, {Jens D} and Christensen, {Kent L} and Charlotte Strandhave and Tietze, {Ida N} and Novosel, {Marija K} and Bibby, {Bo M} and Jensen, {Lars T} and Erik Sloth and Bente Jespersen",

year = "2014",

month = sep,

doi = "10.1038/ki.2014.69",

language = "English",

volume = "86",

pages = "625--37",

journal = "Kidney International",

issn = "0085-2538",

publisher = "Elsevier",

number = "3",

}

TY - JOUR

T1 - No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients

AU - Peters, Christian D

AU - Kjaergaard, Krista D

AU - Jensen, Jens D

AU - Christensen, Kent L

AU - Strandhave, Charlotte

AU - Tietze, Ida N

AU - Novosel, Marija K

AU - Bibby, Bo M

AU - Jensen, Lars T

AU - Sloth, Erik

AU - Jespersen, Bente

PY - 2014/9

Y1 - 2014/9

N2 - Agents blocking the renin-angiotensin-aldosterone system are frequently used in patients with end-stage renal disease, but whether they exert beneficial cardiovascular effects is unclear. Here the long-term effects of the angiotensin II receptor blocker, irbesartan, were studied in hemodialysis patients in a double-blind randomized placebo-controlled 1-year intervention trial using a predefined systolic blood pressure target of 140 mm Hg (SAFIR study). Each group of 41 patients did not differ in terms of age, blood pressure, comorbidity, antihypertensive treatment, dialysis parameters, and residual renal function. Brachial blood pressure decreased significantly in both groups, but there was no significant difference between placebo and irbesartan. Use of additional antihypertensive medication, ultrafiltration volume, and dialysis dosage were not different. Intermediate cardiovascular end points such as central aortic blood pressure, carotid-femoral pulse wave velocity, left ventricular mass index, N-terminal brain natriuretic prohormone, heart rate variability, and plasma catecholamines were not significantly affected by irbesartan treatment. Changes in systolic blood pressure during the study period significantly correlated with changes in both left ventricular mass and arterial stiffness. Thus, significant effects of irbesartan on intermediate cardiovascular end points beyond blood pressure reduction were absent in hemodialysis patients.

AB - Agents blocking the renin-angiotensin-aldosterone system are frequently used in patients with end-stage renal disease, but whether they exert beneficial cardiovascular effects is unclear. Here the long-term effects of the angiotensin II receptor blocker, irbesartan, were studied in hemodialysis patients in a double-blind randomized placebo-controlled 1-year intervention trial using a predefined systolic blood pressure target of 140 mm Hg (SAFIR study). Each group of 41 patients did not differ in terms of age, blood pressure, comorbidity, antihypertensive treatment, dialysis parameters, and residual renal function. Brachial blood pressure decreased significantly in both groups, but there was no significant difference between placebo and irbesartan. Use of additional antihypertensive medication, ultrafiltration volume, and dialysis dosage were not different. Intermediate cardiovascular end points such as central aortic blood pressure, carotid-femoral pulse wave velocity, left ventricular mass index, N-terminal brain natriuretic prohormone, heart rate variability, and plasma catecholamines were not significantly affected by irbesartan treatment. Changes in systolic blood pressure during the study period significantly correlated with changes in both left ventricular mass and arterial stiffness. Thus, significant effects of irbesartan on intermediate cardiovascular end points beyond blood pressure reduction were absent in hemodialysis patients.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Angiotensin II Type 1 Receptor Blockers

KW - Arterial Pressure

KW - Biphenyl Compounds

KW - Catecholamines

KW - Double-Blind Method

KW - Female

KW - Heart Rate

KW - Heart Ventricles

KW - Humans

KW - Hypertension

KW - Kidney Failure, Chronic

KW - Male

KW - Middle Aged

KW - Natriuretic Peptide, Brain

KW - Organ Size

KW - Peptide Fragments

KW - Pulse Wave Analysis

KW - Renal Dialysis

KW - Tetrazoles

KW - Vascular Stiffness

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.1038/ki.2014.69

DO - 10.1038/ki.2014.69

M3 - Journal article

C2 - 24670413

SN - 0085-2538

VL - 86

SP - 625

EP - 637

JO - Kidney International

JF - Kidney International

IS - 3

ER -

No significant effect of angiotensin II receptor blockade on intermediate cardiovascular end points in hemodialysis patients

Abstract

Keywords

Access to Document

Fingerprint

Cite this