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Related Experiment Videos

Renal function during antihypertensive treatment

S Madhavan1, D Stockwell, H Cohen

  • 1Albert Einstein College of Medicine, Department of Epidemiology and Social Medicine, Bronx, New York 10461.

Lancet (London, England)
|March 25, 1995
PubMed
Summary
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Antihypertensive therapy did not significantly alter renal function in mild-to-moderate hypertensive patients over five years. Changes in serum creatinine were likely due to regression toward the mean, not treatment effects.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Pharmacology

Background:

  • Hypertension is a major risk factor for chronic kidney disease.
  • The impact of antihypertensive therapy on renal function in hypertensive patients requires further elucidation.
  • Serum creatinine is a key biomarker for assessing kidney function.

Purpose of the Study:

  • To investigate the association between renal function and blood pressure control during antihypertensive treatment.
  • To examine changes in serum creatinine levels in black and white hypertensive men over a 5-year period.
  • To determine if antihypertensive therapy influences the course of renal function in mild-to-moderate hypertension.

Main Methods:

  • Longitudinal study of 2125 mild-to-moderate hypertensive men over an average of 5 years.

Related Experiment Videos

  • Measurement of serum creatinine to assess renal function.
  • Analysis of in-treatment blood pressure, stratified by race and diastolic pressure levels.
  • Statistical analysis including analysis of covariance and multiple regression.

    • Main Results:

    • Black patients had significantly higher initial and final serum creatinine levels compared to white patients.
    • A small increase in serum creatinine was observed in black patients, while white patients showed a slight decrease.
    • In-treatment diastolic blood pressure was not independently associated with final serum creatinine levels.
    • Less than 2% of patients reached a critical level of renal insufficiency (serum creatinine >= 177 mumol/L).

    Conclusions:

    • Antihypertensive treatment does not appear to be a significant determinant of renal function changes in mild-to-moderate hypertensive patients.
    • Observed changes in renal function are likely attributable to regression toward the mean.
    • Patients with significant renal insufficiency may have underlying intrinsic renal disease predating antihypertensive therapy.