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*
Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain
Clinica Medica, University of Pisa, Italy
Division of Hypertension, Department of Internal Medicine, University of
Michigan Medical Center, Ann Arbor, Michigan
§
Clinical Hypertension Research, Department of Public Health and Social
Sciences, University of Uppsala, Uppsala, Sweden
||
AstraZeneca R&D, Mölndal,
Sweden
¶
Nordic School of Public Health, Göteborg,
Sweden
§§
Centro di Fisiologia Clinica e Ipertensione, University of Milan, Ospedale
Maggiore di Milano and Instituto Auxologico Italiano, Milan, Italy.
Correspondence to Dr. Luis M. Ruilope, Unidad de Hipertension, Hospital 12 de Octubre, 28041 Madrid, Spain. Phone: +34-91-390-82-84; Fax: +34-91-576-56-44; E-mail: Luis_M_Ruilope{at}teleline.es
Abstract. This article reports further analyses of the
Hypertension Optimal Treatment (HOT) Study data with the aim to describe
(1) the value of baseline serum creatinine and its clearance
(estimated by Cockroft and Gault formula) as predictors of cardiovascular
events, (2) the effects of intensive lowering of BP on cardiovascular
events and renal function in patients with reduced renal function, and
(3) the effects on cardiovascular events of adding acetylsalicylic
acid to antihypertensive therapy in patients with reduced renal function. The
results show that (1) baseline elevation in serum creatinine and a
reduction in estimated creatinine clearance are powerful predictors of
cardiovascular events and death. (2) Reduced renal function at
baseline did not preclude the desired control of BP. In contrast to patients
with normal renal function, the incidence of major cardiovascular events did
not differ in the three groups of patients with mild renal insufficiency
randomized to different diastolic BP targets. No significant changes in serum
creatinine were seen at the end of the 3.8-yr treatment period in the great
majority of patients. However, there was a small group of patients (0.58% of
the total study population) whose renal function deteriorated (increase
30% over baseline and final serum creatinine concentration 2 mg/dl)
despite satisfactory reduction of diastolic BP. (3) The results of
this reanalysis of the HOT Study suggest though do not prove that the
association of acetylsalicylic acid with intensive antihypertensive therapy
offers additional benefit in hypertensive patients with reduced renal
function.
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J.F.E Mann, I Dulau-Florea, and J Franke Looking for people at high cardiovascular risk? Look at serum-creatinine Eur. Heart J., March 1, 2003; 24(5): 381 - 383. [Full Text] [PDF]
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M. Tonelli, L. Moye, F. M. Sacks, B. Kiberd, G. Curhan, and for the Cholesterol and Recurrent Events (CARE) Tr Pravastatin for Secondary Prevention of Cardiovascular Events in Persons with Mild Chronic Renal Insufficiency Ann Intern Med, January 21, 2003; 138(2): 98 - 104. [Abstract] [Full Text] [PDF]
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A. Schulz, A. Litfin, P. Kossmehl, and R. Kreutz Genetic Dissection of Increased Urinary Albumin Excretion in the Munich Wistar Fromter Rat J. Am. Soc. Nephrol., November 1, 2002; 13(11): 2706 - 2714. [Abstract] [Full Text] [PDF]
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L. M. Ruilope The Kidney as a Sensor of Cardiovascular Risk in Essential Hypertension J. Am. Soc. Nephrol., November 1, 2002; 13(90003): S165 - 168. [Abstract] [Full Text]
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P. W. de Leeuw, L. Thijs, W. H. Birkenhager, S. M. Voyaki, A. D. Efstratopoulos, R. H. Fagard, G. Leonetti, C. Nachev, J. C. Petrie, J. L. Rodicio, et al. Prognostic Significance of Renal Function in Elderly Patients with Isolated Systolic Hypertension: Results from the Syst-Eur Trial J. Am. Soc. Nephrol., September 1, 2002; 13(9): 2213 - 2222. [Abstract] [Full Text] [PDF]
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D. N. Reddan and P. S. Klassen Chronic Kidney Disease and Cardiovascular Risk: Time to Focus on Therapy J. Am. Soc. Nephrol., September 1, 2002; 13(9): 2415 - 2416. [Full Text] [PDF]
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L. M. Ruilope, D. J. van Veldhuisen, E. Ritz, and T. F. Luscher Renal function: the Cinderella of cardiovascular risk profile J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1782 - 1787. [Abstract] [Full Text] [PDF]
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J. Segura, C. Campo, J. L. Rodicio, and L. M. Ruilope ACE Inhibitors and Appearance of Renal Events in Hypertensive Nephrosclerosis Hypertension, September 1, 2001; 38(3): 645 - 649. [Abstract] [Full Text] [PDF]
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J. F.E. Mann, H. C. Gerstein, J. Pogue, J. Bosch, S. Yusuf, and for the HOPE Investigators Renal Insufficiency as a Predictor of Cardiovascular Outcomes and the Impact of Ramipril: The HOPE Randomized Trial Ann Intern Med, April 17, 2001; 134(8): 629 - 636. [Abstract] [Full Text] [PDF]
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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673
