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Effects of candesartan and amlodipine on cardiovascular events in hypertensive patients with chronic kidney disease: sub analysis of the CASE-J Study

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We examined the effects of candesartan and amlodipine on cardiovascular events in hypertensive patients with chronic kidney
disease (CKD) using the data from the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial. CKD was
defined as proteinuria and/or decreased GFR (o60 ml per min per 1.73m2) at enrollment. Among 2720 subjects with CKD,
there were 1376 and 1344 patients in the candesartan and the amlodipine group, respectively. During a 3.2-year follow-up,
cardiovascular event rate did not differ in the two groups (7.2% for candesartan and 7.6% for amlodipine). In the subgroup
analysis based on the CKD stage, there were no significant differences in the incidence rates of cardiovascular events between
the two groups in stages 1+2 and 3 CKD. In stage 4 CKD, however, candesartan reduced the incidence of cardiovascular events
(55% risk reduction), particularly of renal events (81% risk reduction), compared with amlodipine. Furthermore, composite
cardiovascular events were increased as the CKD stage progressed, and this effect was exaggerated in the presence of
proteinuria. Finally, the new onset of diabetes was less in the candesartan-based regimen in stage 3 CKD. In conclusion,
candesartan protected hypertensive patients with CKD more potently against renal events, particularly in moderately–to–severely
impaired CKD. Furthermore, candesartan prevented a new onset of diabetes in CKD, which would be favorable for the long-term
management of CKD.

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: .,

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Language

English

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Classification

NONE

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Subject(s)

Candesartan
Amlodipine
Canderin Duo
Cardiovascular events
Chronic Kidney Disease

Specific Detail Info

Hypertension Research (2009) 32, 505–512

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