ARBs 'may be the best for hypertension with CKD'

Hypertensive patients with chronic kidney disease (CKD) may be best treated with an angiotensin receptor blocker (ARB), suggests Japanese research.

The findings come from sub-analysis of a study into the benefits of ARBs in patients with coronary artery disease (CAD).

Risk of major adverse cardiac events was reduced by 21 per cent in patients with impaired renal function and ARBs reduced the risk of new-onset diabetes by 63 per cent, delegates were told at the American Heart Association scientific sessions in Orlando, Florida.

For the study, over 2,000 patients with CAD were randomly assigned to treatment with the ARB candesartan or standard therapy. In Japan this is a beta-blocker, followed by a diuretic.

But 71 per cent of patients were also taking ACE inhibitor, said lead researcher Dr Hiroshi Kasanuki from Tokyo Women's Medical University.

The study showed that ARBs had little effect on the risk of major adverse cardiac events in these patients at four-year follow-up, reducing risk by a non-significant 11 per cent.

Professor Gordon Tomaselli, chairman of the committee of the scientific sessions programme, urged cautious interpretation of data, but said there may be value for ARB treatment in diabetic patients.

'You may consider use of this in these patients and those with chronic renal impairment,' he said.

AHA scientific sessions 4-7 November 2007, Orlando, Florida

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