Key result
CCBs linked to ~5 mmHg less maximal daily SBP variation versus ARBs in ESRD.
Why the study?
Do calcium channel blockers improve blood pressure stability compared to angiotensin receptor blockers in hypertensive patients with end-stage renal disease on hemodialysis?
Observational (n=20)
Do calcium channel blockers improve blood pressure stability compared to angiotensin receptor blockers in hypertensive patients with end-stage renal disease on hemodialysis?
Absolute Event Rate: 14% vs 19%
p-value: p=<0.01
Calcium channel blockers provide better blood pressure stability than ARBs by preventing substantial drops in systolic blood pressure after hemodialysis in patients with end-stage renal disease.
May favor calcium channel blockers over ARBs for BP stability in ESRD on hemodialysis; hypothesis-generating and requires randomized confirmation.
Hypertension is a well-known cardiovascular risk. Patients with end-stage renal diseases frequently suffer hypertension. Furthermore, daily variations of blood pressure are relatively large in patients treated with hemodialysis, partly due to ultrafiltration. Twenty hypertensive patients with end-stage renal diseases whose blood pressure was controlled by a single antihypertensive agent, either angiotensin receptor antagonist (ARB) or calcium channel blocker (CCB), were enrolled into the study. Home blood pressure measurements were also performed. Average systolic and diastolic blood pressures were similar between two agents. However, variations of systolic blood pressure during ARB treatment were greater than those of CCB, and maximal differences in daily systolic blood pressure during treatment with ARB (19±7 mmHg) were greater than those with CCB (14±6 mmHg, p<0.01). Systolic blood pressure measured after hemodialysis under ARB therapy (110±6 mmHg) was lower than that of CCB (118±6 mmHg, p<0.05). Daily variations of diastolic blood pressure were similar between ARB and CCB periods. Our results indicate that variations of systolic blood pressure during ARB treatment are larger than CCB, and suggest that CCB is useful to obtain the better quality of blood pressure control, improving blood pressure stability by preventing substantial drops in blood pressure in hypertensive patients with end-stage renal diseases.
No takes yet. Share an insight, caveat, or question.
Takenaka et al. (2014) conducted an observational in Hypertension and end-stage renal disease (n=20). Calcium channel blocker (CCB) vs. Angiotensin receptor antagonist (ARB) was evaluated on Maximal differences in daily systolic blood pressure (p=<0.01). Calcium channel blockers were associated with smaller maximal differences in daily systolic blood pressure compared to ARBs (14±6 vs 19±7 mmHg, p<0.01) in patients with end-stage renal disease.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: