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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

Renal outcomes in hypertensive Black patients at high cardiovascular risk

Matthew R Weir1, George L Bakris, Michael A Weber

  • 1Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mweir@medicine.umaryland.edu

Kidney International
|December 23, 2011
PubMed

Insights

Benazepril plus amlodipine better stabilized kidney function than benazepril plus hydrochlorothiazide in non-Black patients with systolic hypertension. Black patients showed a higher risk for increased serum creatinine levels.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • The ACCOMPLISH trial investigated cardiovascular event reduction in patients with systolic hypertension.
  • High cardiovascular risk patients were randomized to benazepril plus hydrochlorothiazide or amlodipine.
  • The trial included a significant proportion of participants of Black ethnicity.

Purpose of the Study:

  • To compare the efficacy of two combination antihypertensive therapies on kidney disease progression.
  • To assess differences in kidney outcomes between Black and non-Black patients.

Main Methods:

  • A 3-year, multicenter, double-blind, event-driven trial.
  • Randomization to benazepril plus hydrochlorothiazide versus benazepril plus amlodipine.
  • Kidney disease endpoint: doubling of serum creatinine, end-stage renal disease, or death.

Main Results:

  • No difference in the composite kidney disease endpoint between Black and non-Black patients.
  • Black patients had a higher likelihood of a >50% increase in serum creatinine.
  • Benazepril plus amlodipine stabilized estimated glomerular filtration rate (eGFR) more effectively in non-Blacks.
  • No difference in mean eGFR loss between therapies in Black patients.

Conclusions:

  • Benazepril plus amlodipine demonstrated superior kidney protection compared to benazepril plus hydrochlorothiazide in non-Black patients.
  • Black patients exhibited a higher risk for advanced serum creatinine increases, irrespective of treatment.
  • Race is an important factor in antihypertensive treatment outcomes for kidney protection.

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