Key result
In patients with chronic kidney disease, 6 months of treatment with ACEIs or ARBs reduced total cholesterol by 7.77% and increased HDL-C by 5.94%, though these changes were not significantly different from those seen with other antihypertensive agents.
Why the study?
It was unknown whether renin-angiotensin system blockade with ACE inhibitors or ARBs affects the plasma lipid profile in patients with chronic kidney disease.
Does ACEI or ARB therapy improve plasma lipid profiles in hypertensive patients with CKD compared to other antihypertensive agents?
Cohort (n=94)
No
Does ACEI or ARB therapy improve plasma lipid profiles in hypertensive patients with CKD compared to other antihypertensive agents?
Inhibition of the renin-angiotensin system with ACEIs or ARBs modestly improves lipid profiles, particularly by increasing HDL-C and reducing total cholesterol, in non-dyslipidemic hypertensive patients with chronic kidney disease.
Answers are grounded in this paper and cite their sources.
ACEI/ARB use was associated with improved lipids in CKD; leaves open effects on CV outcomes in randomized trials.
The aim of this study was to evaluate whether the blockade of renin-angiotensin system (RAS), achieved by angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), could affect the plasma lipid profile in chronic kidney disease (CKD) patients. Ninety-four hypertensive patients with CKD (stage 3-5) were enrolled. Forty-nine patients were treated with either ACEIs or ARBs daily for 6 months, and forty-five patients were treated with other antihypertensive agents (calcium channel blockers (amlodipine), b blockers, diuretics) as positive control group. Creatinine, estimated glomerular filtration rate (eGFR), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) levels measurements were performed before and after the six-month treatment. An improvement in serum lipids levels in hypertensive patients with CKD resulted from RAS blocked therapy and other antihypertensive agents. Both treatment groups significantly decreased total cholesterol (TC), by 7.77% in ACEIs/ARBs group (p≤0.01) and 6.42% in other antihypertensive group (p≤0.05). In CKD patients treated with ACEIs/ARBs, levels of TG (3.29%), and LDL-C (3.15%) dropped more than with other antihypertensive medications (2.12%, and 1.19% respectively). RAS blocked therapy significantly increased HDL-C levels in CKD patients by 5.94% (p≤0.05). The results indicate that RAS blockade therapy with ACEIs or ARB positively affects lipid profile, which may improve the cardiovascular risks caused by CKD.
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Salamah et al. (2023) conducted a cohort in Chronic Kidney Disease (stage 3-5) with essential hypertension (n=94). ACEIs or ARBs vs. Other antihypertensive agents (calcium channel blockers, beta blockers, diuretics) was evaluated on Reduction in total cholesterol (p=0.832). In patients with chronic kidney disease, 6 months of treatment with ACEIs or ARBs reduced total cholesterol by 7.77% and increased HDL-C by 5.94%, though these changes were not significantly different from those seen with other antihypertensive agents.
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