Renal Protective Effect in Hypertensive Patients: The High Doses of Angiotensin II Receptor Blocker (HARB) Study

Ohishi, Mitsuru; Takagi, Takashi; Ito, Norihisa; Tatara, Yuji; Hayashi, Norihiro; Shiota, Atsushi; Iwamoto, Yoshihiro; Katsuya, Tomohiro; Rakugi, Hiromi; Ogihara, Toshio

doi:10.1291/hypres.30.1187

Cited by 11 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, since ARB is reported to increase serum potassium levels less and better tolerated than ACE inhibitors, ARB is likely to be a better choice for first-line treatment for ESRD patients on CAPD therapy [46]. Furthermore, although candesartan and valsartan are frequently used ARB and have demonstrated clinical efficacy in large trials for chronic heart failure patients [47, 48], a previous study showed that the BP-lowering and renal protective effects of these ARBs may differ in hypertensive patients [49]. Thus, in this study, we chose these two different ARBs, candesartan and valsartan, to seek a possible difference in therapeutic effects between two different ARBs, but we could not find any significant differences in beneficial effects on BP variability and in suppression of pathological cardiovascular remodeling between candesartan and valsartan.…”

Section: Discussionmentioning

confidence: 99%

Effects of Angiotensin II Type 1 Receptor Blocker on Blood Pressure Variability and Cardiovascular Remodeling in Hypertensive Patients on Chronic Peritoneal Dialysis

et al. 2009

View full text Add to dashboard Cite

Aims: In this study, we examined whether addition of an angiotensin II type 1 receptor blocker (ARB), candesartan or valsartan, to conventional antihypertensive treatment could improve blood pressure (BP) variability in hypertensive patients on peritoneal dialysis. Methods: 45 hypertensive patients on chronic peritoneal dialysis therapy were randomly assigned to the ARB treatment groups either by candesartan (n = 15) or valsartan (n = 15), or the control group (n = 15). At baseline and 6 months after the treatment, 24-hour ambulatory BP monitoring, echocardiography, and measurement of brachial-ankle pulse wave velocity (baPWV) were performed. Results: After the 6 months of treatment, 24-hour ambulatory BP values were similarly decreased in both the control group and ARB groups. However, short-term BP variability assessed on the basis of the standard deviation of 24-hour ambulatory BP was significantly decreased in the ARB groups, but remained unchanged in the control group. Furthermore, parameters of cardiovascular remodeling assessed by natriuretic peptides, echocardiography, and baPWV were significantly improved in the ARB groups but not in the control group. Conclusion: ARB treatment and control antihypertensive treatment similarly controlled 24-hour ambulatory BP values in hypertensive patients on peritoneal dialysis. However, ARB treatment is beneficial for the suppression of pathological cardiovascular remodeling with a decrease in BP variability.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of Angiotensin II Type 1 Receptor Blocker on Blood Pressure Variability and Cardiovascular Remodeling in Hypertensive Patients on Chronic Peritoneal Dialysis

et al. 2009

View full text Add to dashboard Cite

show abstract

“…In this respect, several clinical studies have shown that the use of higher than recommended doses of ARBs could safely produce an additional decrease in UAE without inducing a greater fall in BP [17][18][19][20][21][22]. Thus, a high dose of ARB could be an alternative therapeutic strategy to lower BP and proteinuria in proteinuric hypertensive patients.…”

Section: Introductionmentioning

confidence: 99%

Combining blockers of the renin-angiotensin system or increasing the dose of an angiotensin II receptor antagonist in proteinuric patients: a randomized triple-crossover study

Meier¹,

Meier²,

Tremblay³

et al. 2011

Journal of Hypertension

View full text Add to dashboard Cite

show abstract

“…We previously reported that the administration of valsartan at 160 mg per day was more effective for reducing BP and proteinuria than the administration of candesartan at 12 mg per day in patients with hypertension. 10 The Val-HeFT 11 and VALIANT 12 trials demonstrated that 320 mg per day of valsartan had beneficial effects on the prognoses for chronic heart failure and ischemic heart disease. However, in Japan, the permitted maximum doses of candesartan and valsartan are lower than the doses used in those clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Strong suppression of the renin–angiotensin system has a renal-protective effect in hypertensive patients: High-dose ARB with ACE inhibitor (Hawaii) study

et al. 2010

Self Cite

View full text Add to dashboard Cite

The principal means for reducing proteinuria in patients with chronic kidney disease are strong blockade of the reninangiotensin system and strict regulation of blood pressure (BP). This study compared the efficacy of the maximum permissible doses of two common angiotensin receptor blockers (ARBs), namely valsartan (maximum dose¼160 mg per day) and olmesartan (maximum dose¼40 mg per day). We also investigated whether a high-dose ARB or the combination of an angiotensin-converting enzyme inhibitor with a high-dose ARB would be more renal protective. We recruited 87 poorly controlled hypertensive patients. In the first study, 50 patients without proteinuria were switched from valsartan (160 mg per day) to olmesartan (40 mg per day) for 4 months. In the second study, 37 patients with proteinuria were randomized to either switch from valsartan 160 mg per day to 40 mg per day olmesartan (n¼19; Olm-G) or addition of 2.5-10 mg per day imidapril (stepped up by 2.5 mg per month) to valsartan at 160 mg per day (n¼18; Imi-G). After 4 months, the BP level decreased (first study) from 157/88 mm Hg to 145/ 82 mm Hg (Po0.001) and (second study) from 149/86 mm Hg to 135/77 mm Hg and 145/82 mm Hg for Olm-G and Imi-G, respectively. Furthermore, in the second study, urinary protein/creatinine excretion was reduced from 2.0±1.8 g g À1 to 0.8 ± 0.8 g g À1 (P¼0.0242) in Olm-G and from 1.4 ± 1.3 g g À1 to 0.9 ± 1.0 g g À1 (P¼0.0398) in Imi-G. The significance persisted after adjustment for BP or other risk factors. Our results suggested that the maximum dose of olmesartan was more effective than that of valsartan and comparable with the combination of valsartan and imidapril for reducing BP and proteinuria in poorly controlled hypertensive patients.

show abstract

Renal Protective Effect in Hypertensive Patients: The High Doses of Angiotensin II Receptor Blocker (HARB) Study

Cited by 11 publications

References 27 publications

Effects of Angiotensin II Type 1 Receptor Blocker on Blood Pressure Variability and Cardiovascular Remodeling in Hypertensive Patients on Chronic Peritoneal Dialysis

Effects of Angiotensin II Type 1 Receptor Blocker on Blood Pressure Variability and Cardiovascular Remodeling in Hypertensive Patients on Chronic Peritoneal Dialysis

Combining blockers of the renin-angiotensin system or increasing the dose of an angiotensin II receptor antagonist in proteinuric patients: a randomized triple-crossover study

Strong suppression of the renin–angiotensin system has a renal-protective effect in hypertensive patients: High-dose ARB with ACE inhibitor (Hawaii) study

Contact Info

Product

Resources

About