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Angiotensin receptor blockers reduce left ventricular hypertrophy in dialysis patients: a meta-analysis

Li-Ya Yang1, Xiao Ge, Yan-Li Wang

  • 1Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China.

The American Journal of the Medical Sciences
|September 29, 2012
PubMed

Insights

Angiotensin receptor blockers (ARBs) significantly reduce left ventricular hypertrophy (LVH) in dialysis patients. ARB therapy shows similar effectiveness to ACE inhibitors, with no added benefit from combining ARBs and ACEIs.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Left ventricular hypertrophy (LVH) is a significant complication and mortality predictor in end-stage renal disease patients.
  • The impact of angiotensin receptor blockers (ARBs) on LVH in dialysis patients remains understudied.
  • Hypertension management often involves angiotensin II blockades.

Purpose of the Study:

  • To meta-analyze the effect of ARBs on LVH and left ventricular function in patients undergoing maintenance dialysis.
  • To compare ARBs with non-ARBs, ACE inhibitors, and combined ARB-ACE inhibitor therapies.

Main Methods:

  • Systematic literature search of PubMed, Embase, and Cochrane Central Register of Controlled Trials up to November 2010.
  • Analysis of data from 6 randomized controlled trials involving 207 participants.
  • Utilized Review Manager software for data analysis.

Main Results:

  • ARB therapy led to greater regression of left ventricular mass index (LVMi) compared to non-ARBs (P = 0.002).
  • No significant difference in left ventricular ejection fraction (LVEF) was observed between ARB and non-ARB groups (P = 0.30).
  • ARBs showed comparable effectiveness to ACE inhibitors (ACEI) for LVMi and LVEF, and combination therapy offered no additional benefit.

Conclusions:

  • ARBs are effective in reducing LVH in dialysis patients.
  • ARB therapy demonstrates favorable effectiveness comparable to ACE inhibitors.
  • Combining ARBs with ACEIs does not provide additional benefits for LVH in hemodialysis patients.
Abstract

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