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[Large clinical trials of ARB in Japan and its reflection to new guidelines]

Hiroaki Matsuoka1

  • 1Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University School of Medicine.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|April 8, 2009
PubMed

Insights

Angiotensin II receptor blockers (ARBs) show similar cardiovascular event prevention as calcium channel blockers in high-risk patients. ARBs also offer superior new-onset diabetes prevention and renoprotective effects in type 2 diabetes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Nephrology

Context:

  • Large-scale clinical trials of Angiotensin II Receptor Blockers (ARBs) have been conducted in Japan.
  • These trials focus on high-risk hypertensive patients, including those with coronary heart disease, congestive heart failure, and type 2 diabetes.

Purpose:

  • To evaluate the efficacy of ARBs compared to other antihypertensive agents, specifically calcium antagonists.
  • To assess the renoprotective effects of ARBs in patients with type 2 diabetes.
  • To inform the development of new clinical guidelines (JSH2009).

Summary:

  • The CASE-J trial demonstrated that candesartan (ARB) and amlodipine (calcium antagonist) have similar effects on preventing cardiovascular events in high-risk hypertensive patients, but ARBs were more effective in preventing new-onset diabetes.
  • The JIKEI HEART trial showed that valsartan treatment reduced cardiovascular events in hypertensive patients with coronary heart disease and congestive heart failure compared to non-ARB treatment.
  • The INNOVATION and SMART trials indicated renoprotective effects of telmisartan and valsartan in type 2 diabetic patients.

Impact:

  • Findings support ARBs as a valuable therapeutic option for cardiovascular risk reduction and diabetes prevention in hypertensive patients.
  • Evidence from these trials is crucial for updating hypertension management guidelines in Japan.
  • The results highlight the potential benefits of ARBs in protecting kidney function in diabetic patients.

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