title: Angiotensin receptor blockers reduce left ventricular hypertrophy in dialysis patients:  a meta-analysis.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) is a major cardiovascular complication and an important predictor of mortality in patients with end-stage renal disease. Angiotensin II blockades have been widely used in the treatment of hypertension; however, the influence of angiotensin receptor blockers (ARBs) on LVH in dialysis patients has not been thoroughly studied. In this meta-analysis, the authors analyzed the effect of ARBs on LVH and left ventricular function in patients on maintenance dialysis.
  
  
  METHODS
  The authors did systematic search of PubMed, Embase and Cochrane Central Register of Controlled Trials, until November 2010. Data extracted from the literature were analyzed with the Review Manager.
  
  
  RESULTS
  The results of 6 randomized controlled trials (207 participants) reveal that ARB group had a greater regression of left ventricular mass index (LVMi) when compared with non-ARB group (P = 0.002) in dialysis patients while no significant difference for left ventricular ejection fraction (LVEF; P = 0.30). The ARB group had a nonsignificantly greater therapeutic value of LVMi or LVEF when compared with angiotensin-converting enzyme inhibitor (ACEI; P = 0.74 and 0.49, respectively). No significant alterations were observed in LVMi and LVEF between the combination of ARBs and ACEIs and ARBs group (P = 0.43 and 0.24, respectively).
  
  
  CONCLUSIONS
  ARBs are associated with a greater reduction in LVH in patients on dialysis. The ARB therapy tends to have a similar favorable effectiveness as ACEI; however, the combination of ARBs with ACEIs did not show additional benefit to LVH in patients on hemodialysis.
authors.affiliation: Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China.
authors.forename: Li-Ya
authors.initials: LY
authors.lastname: Yang
authors.forename: Xiao
authors.initials: X
authors.lastname: Ge
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Wang
authors.forename: Kun-Ling
authors.initials: KL
authors.lastname: Ma
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Xiao-Liang
authors.initials: XL
authors.lastname: Zhang
authors.forename: Bi-Cheng
authors.initials: BC
authors.lastname: Liu
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000150:complications*; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors