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.
authors.affiliation: 1] Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark [2] Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Peters
authors.affiliation: 1] Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark [2] Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Krista D
authors.initials: KD
authors.lastname: Kjaergaard
authors.affiliation: 1] Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark [2] Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Jens D
authors.initials: JD
authors.lastname: Jensen
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Kent L
authors.initials: KL
authors.lastname: Christensen
authors.affiliation: Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Strandhave
authors.affiliation: Department of Medicine, Viborg Regional Hospital, Viborg, Denmark.
authors.forename: Ida N
authors.initials: IN
authors.lastname: Tietze
authors.affiliation: Department of Medicine, Fredericia Hospital, Fredericia, Denmark.
authors.forename: Marija K
authors.initials: MK
authors.lastname: Novosel
authors.affiliation: Department of Biostatistics, Aarhus University, Aarhus, Denmark.
authors.forename: Bo M
authors.initials: BM
authors.lastname: Bibby
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark.
authors.forename: Lars T
authors.initials: LT
authors.lastname: Jensen
authors.affiliation: Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Sloth
authors.affiliation: 1] Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark [2] Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Bente
authors.initials: B
authors.lastname: Jespersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects; D001713:Biphenyl Compounds / Q000627:therapeutic use*; D002395:Catecholamines / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D000077405:Irbesartan; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009929:Organ Size; D010446:Peptide Fragments / Q000097:blood; D063177:Pulse Wave Analysis; D006435:Renal Dialysis; D013777:Tetrazoles / Q000627:therapeutic use*; D059289:Vascular Stiffness / Q000187:drug effects
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001713:Biphenyl Compounds; D002395:Catecholamines; D010446:Peptide Fragments; D013777:Tetrazoles; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000077405:Irbesartan