Publication

Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy: a post hoc analysis of the combined RENAAL and IDNT trials

Holtkamp, F. A., de Zeeuw, D., de Graeff, P. A., Laverman, G. D., Berl, T., Remuzzi, G., Packham, D., Lewis, J. B., Parving, H-H. & Lambers Heerspink, H. J., Jun-2011, In : European Heart Journal. 32, 12, p. 1493-1499 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Holtkamp, F. A., de Zeeuw, D., de Graeff, P. A., Laverman, G. D., Berl, T., Remuzzi, G., ... Lambers Heerspink, H. J. (2011). Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy: a post hoc analysis of the combined RENAAL and IDNT trials. European Heart Journal, 32(12), 1493-1499. https://doi.org/10.1093/eurheartj/ehr017

Author

Holtkamp, Frank A. ; de Zeeuw, Dick ; de Graeff, Pieter A. ; Laverman, Gozewijn D. ; Berl, Tom ; Remuzzi, Giuseppe ; Packham, David ; Lewis, Julia B. ; Parving, Hans-Henrik ; Lambers Heerspink, Hiddo J. / Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy : a post hoc analysis of the combined RENAAL and IDNT trials. In: European Heart Journal. 2011 ; Vol. 32, No. 12. pp. 1493-1499.

Harvard

Holtkamp, FA, de Zeeuw, D, de Graeff, PA, Laverman, GD, Berl, T, Remuzzi, G, Packham, D, Lewis, JB, Parving, H-H & Lambers Heerspink, HJ 2011, 'Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy: a post hoc analysis of the combined RENAAL and IDNT trials', European Heart Journal, vol. 32, no. 12, pp. 1493-1499. https://doi.org/10.1093/eurheartj/ehr017

Standard

Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy : a post hoc analysis of the combined RENAAL and IDNT trials. / Holtkamp, Frank A.; de Zeeuw, Dick; de Graeff, Pieter A.; Laverman, Gozewijn D.; Berl, Tom; Remuzzi, Giuseppe; Packham, David; Lewis, Julia B.; Parving, Hans-Henrik; Lambers Heerspink, Hiddo J.

In: European Heart Journal, Vol. 32, No. 12, 06.2011, p. 1493-1499.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Holtkamp FA, de Zeeuw D, de Graeff PA, Laverman GD, Berl T, Remuzzi G et al. Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy: a post hoc analysis of the combined RENAAL and IDNT trials. European Heart Journal. 2011 Jun;32(12):1493-1499. https://doi.org/10.1093/eurheartj/ehr017


BibTeX

@article{9371bd747f244b62961ee34d614fda55,
title = "Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy: a post hoc analysis of the combined RENAAL and IDNT trials",
abstract = "Aims The long-term cardioprotective effect of angiotensin receptor blockers (ARBs) is associated with the short-term lowering of its primary target blood pressure, but also with the lowering of albuminuria. Since the individual blood pressure and albuminuria response to an ARB varies between and within an individual, we tested whether the variability and discordance in systolic blood pressure (SBP) and albuminuria response to ARB therapy are associated with its long-term effect on cardiovascular outcomes.Methods and results The combined data of the RENAAL and IDNT trials were used. We first investigated the extent of variability and discordance in SBP and albuminuria response (baseline to 6 months). Subsequently, we assessed the combined impact of residual Month 6 SBP and albuminuria level with cardiovascular outcome. In ARB-treated patients, 421 patients (34.5{\%}) either had a reduction in SBP but no reduction in albuminuria, or vice versa, indicating substantial discordance in response in these parameters. The initial reduction in SBP and albuminuria independently correlated with cardiovascular protection: HR per 5 mmHg SBP reduction 0.97 (95{\%} CI 0.94-0.99) and HR per decrement log albuminuria 0.87 (95{\%} CI 0.76-0.99). Across all SBP categories at Month 6, a progressively lower cardiovascular risk was observed with a lower albuminuria level. This was particularly evident in patients who reached the guideline recommended SBP target ofConclusion The SBP and albuminuria response to ARB therapy is variable and discordant. Therapies intervening in the renin-angiotensin-aldosterone system with the aim of improving cardiovascular outcomes may therefore require a dual approach targeting both blood pressure and albuminuria.",
keywords = "Diabetic Nephropathy, Albuminuria, Blood pressure, Angiotensin receptor blocker, Cardiovascular disease, CHRONIC KIDNEY-DISEASE, CARDIOVASCULAR OUTCOMES, MICROVASCULAR OUTCOMES, LOWERING DRUGS, IRBESARTAN, LOSARTAN, RAMIPRIL, RISK, MICROALBUMINURIA, TELMISARTAN",
author = "Holtkamp, {Frank A.} and {de Zeeuw}, Dick and {de Graeff}, {Pieter A.} and Laverman, {Gozewijn D.} and Tom Berl and Giuseppe Remuzzi and David Packham and Lewis, {Julia B.} and Hans-Henrik Parving and {Lambers Heerspink}, {Hiddo J.}",
year = "2011",
month = "6",
doi = "10.1093/eurheartj/ehr017",
language = "English",
volume = "32",
pages = "1493--1499",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "12",

}

RIS

TY - JOUR

T1 - Albuminuria and blood pressure, independent targets for cardioprotective therapy in patients with diabetes and nephropathy

T2 - a post hoc analysis of the combined RENAAL and IDNT trials

AU - Holtkamp, Frank A.

AU - de Zeeuw, Dick

AU - de Graeff, Pieter A.

AU - Laverman, Gozewijn D.

AU - Berl, Tom

AU - Remuzzi, Giuseppe

AU - Packham, David

AU - Lewis, Julia B.

AU - Parving, Hans-Henrik

AU - Lambers Heerspink, Hiddo J.

PY - 2011/6

Y1 - 2011/6

N2 - Aims The long-term cardioprotective effect of angiotensin receptor blockers (ARBs) is associated with the short-term lowering of its primary target blood pressure, but also with the lowering of albuminuria. Since the individual blood pressure and albuminuria response to an ARB varies between and within an individual, we tested whether the variability and discordance in systolic blood pressure (SBP) and albuminuria response to ARB therapy are associated with its long-term effect on cardiovascular outcomes.Methods and results The combined data of the RENAAL and IDNT trials were used. We first investigated the extent of variability and discordance in SBP and albuminuria response (baseline to 6 months). Subsequently, we assessed the combined impact of residual Month 6 SBP and albuminuria level with cardiovascular outcome. In ARB-treated patients, 421 patients (34.5%) either had a reduction in SBP but no reduction in albuminuria, or vice versa, indicating substantial discordance in response in these parameters. The initial reduction in SBP and albuminuria independently correlated with cardiovascular protection: HR per 5 mmHg SBP reduction 0.97 (95% CI 0.94-0.99) and HR per decrement log albuminuria 0.87 (95% CI 0.76-0.99). Across all SBP categories at Month 6, a progressively lower cardiovascular risk was observed with a lower albuminuria level. This was particularly evident in patients who reached the guideline recommended SBP target ofConclusion The SBP and albuminuria response to ARB therapy is variable and discordant. Therapies intervening in the renin-angiotensin-aldosterone system with the aim of improving cardiovascular outcomes may therefore require a dual approach targeting both blood pressure and albuminuria.

AB - Aims The long-term cardioprotective effect of angiotensin receptor blockers (ARBs) is associated with the short-term lowering of its primary target blood pressure, but also with the lowering of albuminuria. Since the individual blood pressure and albuminuria response to an ARB varies between and within an individual, we tested whether the variability and discordance in systolic blood pressure (SBP) and albuminuria response to ARB therapy are associated with its long-term effect on cardiovascular outcomes.Methods and results The combined data of the RENAAL and IDNT trials were used. We first investigated the extent of variability and discordance in SBP and albuminuria response (baseline to 6 months). Subsequently, we assessed the combined impact of residual Month 6 SBP and albuminuria level with cardiovascular outcome. In ARB-treated patients, 421 patients (34.5%) either had a reduction in SBP but no reduction in albuminuria, or vice versa, indicating substantial discordance in response in these parameters. The initial reduction in SBP and albuminuria independently correlated with cardiovascular protection: HR per 5 mmHg SBP reduction 0.97 (95% CI 0.94-0.99) and HR per decrement log albuminuria 0.87 (95% CI 0.76-0.99). Across all SBP categories at Month 6, a progressively lower cardiovascular risk was observed with a lower albuminuria level. This was particularly evident in patients who reached the guideline recommended SBP target ofConclusion The SBP and albuminuria response to ARB therapy is variable and discordant. Therapies intervening in the renin-angiotensin-aldosterone system with the aim of improving cardiovascular outcomes may therefore require a dual approach targeting both blood pressure and albuminuria.

KW - Diabetic Nephropathy

KW - Albuminuria

KW - Blood pressure

KW - Angiotensin receptor blocker

KW - Cardiovascular disease

KW - CHRONIC KIDNEY-DISEASE

KW - CARDIOVASCULAR OUTCOMES

KW - MICROVASCULAR OUTCOMES

KW - LOWERING DRUGS

KW - IRBESARTAN

KW - LOSARTAN

KW - RAMIPRIL

KW - RISK

KW - MICROALBUMINURIA

KW - TELMISARTAN

U2 - 10.1093/eurheartj/ehr017

DO - 10.1093/eurheartj/ehr017

M3 - Article

VL - 32

SP - 1493

EP - 1499

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 12

ER -

ID: 5416754