Effects of candesartan and amlodipine on cardiovascular events in hypertensive patients with chronic kidney disease: Subanalysis of the CASE-J Study

Takao Saruta, Koichi Hayashi, Toshio Ogihara, Kazuwa Nakao, Tsuguya Fukui, Kohshiro Fukiyama

研究成果: Article査読

41 被引用数 (Scopus)

抄録

We examined the effects of candesartan and amlodipine on cardiovascular events in hypertensive patients with chronic kidney disease (CKD) using the data from the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial. CKD was defined as proteinuria and/or decreased GFR (<60 ml per min per 1.73 m2) at enrollment. Among 2720 subjects with CKD, there were 1376 and 1344 patients in the candesartan and the amlodipine group, respectively. During a 3.2-year follow-up, cardiovascular event rate did not differ in the two groups (7.2% for candesartan and 7.6% for amlodipine). In the subgroup analysis based on the CKD stage, there were no significant differences in the incidence rates of cardiovascular events between the two groups in stages 1+2 and 3 CKD. In stage 4 CKD, however, candesartan reduced the incidence of cardiovascular events (55% risk reduction), particularly of renal events (81% risk reduction), compared with amlodipine. Furthermore, composite cardiovascular events were increased as the CKD stage progressed, and this effect was exaggerated in the presence of proteinuria. Finally, the new onset of diabetes was less in the candesartan-based regimen in stage 3 CKD. In conclusion, candesartan protected hypertensive patients with CKD more potently against renal events, particularly in moderately-to-severely impaired CKD. Furthermore, candesartan prevented a new onset of diabetes in CKD, which would be favorable for the long-term management of CKD.

本文言語English
ページ(範囲)505-512
ページ数8
ジャーナルHypertension Research
32
6
DOI
出版ステータスPublished - 2009
外部発表はい

ASJC Scopus subject areas

  • 内科学
  • 生理学
  • 循環器および心血管医学

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