Candesartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis--a randomized study.
BACKGROUND
Cardiovascular events are the major determinants of the prognosis of patients on chronic haemodialysis. The present study was designed to investigate whether candesartan, an angiotensin II type-1 receptor blocker, reduces the incidence of cardiovascular events in these patients.


METHODS
A total of 80 chronic haemodialysis patients (male/female, 47/33; mean age +/- SEM, 61 +/- 1 years) in stable condition and with no clinical evidence of cardiac disorders were enrolled. Patients were randomly assigned candesartan 4-8 mg/day (candesartan group; n = 43) or nothing (control group; n = 37), and followed for 19.4 +/- 1.2 months with as endpoint cardiovascular events such as fatal/nonfatal myocardial infarction, unstable angina pectoris, congestive heart failure, severe arrhythmia and sudden death.


RESULTS
Both groups exhibited similar clinical characteristics at baseline. During follow-up, cardiovascular events occurred in seven patients in the candesartan group and 17 in the control group. Kaplan-Meier analysis revealed that cardiovascular events and mortality rates were significantly (P < 0.01) higher in the control group than in the candesartan group (45.9 vs 16.3% and 18.9 vs 0.0%, respectively).


CONCLUSIONS
Candesartan therapy significantly reduces cardiovascular events and mortality in patients on chronic maintenance haemodialysis and therefore improves the prognosis of these patients.
Takahashi
Akihiko
A
Department of Internal Medicine, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan. ydohi@med.nagoya-cu.ac.jp
Takase
Hiroyuki
H
Toriyama
Takayuki
T
Sugiura
Tomonori
T
Kurita
Yutaka
Y
Ueda
Ryuzo
R
Dohi
Yasuaki
Y
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D015996:Survival Rate; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan