Adverse effects of left ventricular hypertrophy in the reduction of endpoints in NIDDM with the angiotensin II antagonist losartan (RENAAL) study

Boner, G; Cooper, ME; McCarroll, Kathleen; Bm, Brenner; Zeeuw, de Dick; Pr, Kowey; Shahinfar, Shahnaz; Dickson, Tania Z.; Crow, RS; Hh, Parving; Investigators, Renaal Study

doi:10.1007/s00125-005-1893-1

Cited by 41 publications

(19 citation statements)

References 45 publications

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“…17 Many studies have sought to understand the pathophysiology of kidney -heart interaction by investigating the impact of renal function on LVH, but few have investigated from the opposite point of view. 8, 9 In the present study, conducted as a subanalysis of the CASE-J trial, we found that renal function improved under strict BP control, and that its improvement in high-risk hypertensive patients was greater in patients without LVH than in those with LVH. LVH is an adaptive response that reduces LV wall stress against volume and pressure overload.…”

Section: Discussionsupporting

confidence: 52%

“…10 In contrast, Boner et al reported that LVH was associated with a significantly increased risk of not only CV events but also the progression of kidney disease in patients with type 2 diabetes and nephropathy. 9 Of 4,703 patients in the CASE-J trial, only 46 (1.0%) experienced a renal event, a much smaller proportion than the 32.9% in the RENALL study, indicating that the CASE-J trial lacked sufficient statistical power to evaluate the impact of LVH on renal events.…”

mentioning

confidence: 96%

“…To date, however, few studies have examined the impact of LVH on renal function in hypertensive patients. 8, 9 Our previous subanalysis of the CASE-J trial reported that cardiac complications, including LVH and ischemic heart disease, were independent predictors of CV events, but not of renal events. 10 In contrast, Boner et al reported that LVH was associated with a significantly increased risk of not only CV events but also the progression of kidney disease in patients with type 2 diabetes and nephropathy.…”

mentioning

confidence: 98%

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Impact of Left Ventricular Hypertrophy on the Time-Course of Renal Function in Hypertensive Patients - A Subanalysis of the CASE-J Trial -

Ueshima

Yasuno

Oba

et al. 2010

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ith progressive aging of the population and an increasing prevalence of hypertension and diabetes mellitus, chronic kidney disease (CKD) remains a worldwide public health problem. As many patients with CKD die of cardiovascular (CV) disease before reaching endstage renal disease, measures against CKD should be undertaken from the viewpoint of improving their prognosis. 1,2Left ventricular hypertrophy (LVH) is a manifestation of target organ damage and an independent risk factor for CV morbidity and mortality. 3,4 Several studies have examined the association of renal dysfunction with LVH and have reported that reduced renal function and albuminuria are risk factors for it. 5-7 LVH is thus common in patients with CKD, indicating kidney -heart interaction. To date, however, few studies have examined the impact of LVH on renal function in hypertensive patients. 8,9 Our previous subanalysis of the CASE-J trial reported that cardiac complications, including LVH and ischemic heart disease, were independent predictors of CV events, but not of renal events. 10 In contrast, Boner et al reported that LVH was associated with a significantly increased risk of not only CV events but also the progression of kidney disease in patients with type 2 diabetes and nephropathy. 9 Of 4,703 patients in the CASE-J trial, only 46 (1.0%) experienced a renal event, a much smaller proportion than the 32.9% in the RENALL study, indicating that the CASE-J trial lacked sufficient statistical power to evaluate the impact of LVH on renal events.In this context, the present study was conducted as a subanalysis of the CASE-J trial aimed at investigating the impact of LVH on the time-course of renal function in highrisk Japanese hypertensive patients. Background: In this subanalysis of the CASE-J, which was conducted to compare the effects of candesartan and amlodipine in Japanese high-risk hypertensive patients, the association of left ventricular hypertrophy (LVH) with renal function is clarified.

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Section: Discussionsupporting

confidence: 52%

mentioning

confidence: 96%

mentioning

confidence: 98%

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Impact of Left Ventricular Hypertrophy on the Time-Course of Renal Function in Hypertensive Patients - A Subanalysis of the CASE-J Trial -

Ueshima

Yasuno

Oba

et al. 2010

Circ J

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“…especially poor prognosis (Boner et al, 2005;Struthers & Morris, 2002;Valensi et al, 1997). Emerging evidence has implicated the diabetic milieu of hyperinsulinemia, insulin resistance, hyperglycemia, and increased non-esterified fatty acids in the pathophysiology of LVH in DM patients.…”

Section: Cardiomyopathies -From Basic Research To Clinical Managementmentioning

confidence: 99%

Diabetic Cardiomyopathy: Cardiac Changes, Pathophysiological Mechanisms, Biologic Markers, and the Available Therapeutic Armamentarium

Hill¹

2012

Cardiomyopathies - From Basic Research to Clinical Management

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“…In a new analysis of the data from the Reduction of Endpoints in NIDDM with Angiotensin II Antagonist Losartan study [32], using the LIFE criteria for LVH, i.e. based on electrocardiographic findings [33], 12% of patients with type 2 diabetes with overt proteinuria were found to have LVH.…”

Section: Left Ventricular Hypertensionmentioning

confidence: 99%

Renal involvement and left ventricular hypertrophy are novel risk factors for morbidity and mortality in diabetes mellitus

Boner

2011

Diabetes Metabolism Res

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SummaryDiabetes mellitus and its complications are major causes of morbidity and mortality. Traditionally hypertension and poor diabetic control have been considered to be major risk factors for the development of cardiac involvement. This review will examine two novel risk factors, namely renal involvement and left ventricular hypertrophy. Renal involvement is manifested by increased excretion of protein in the urine and/or decreasing renal function. Several large studies have shown that both these factors are significant risk factors for cardiac involvement and increased mortality both in diabetic and non-diabetic subjects. There is strong evidence to suggest an association between renal and cardiac involvement. Cardiac hypertrophy is an important risk factor for the development of cardiac involvement. It is generally assumed that ventricular hypertrophy is a result of hypertension. However, it has been shown to be associated with metabolic disorders such as central obesity, diabetes mellitus and hypercholesterolemia, even in the absence of hypertension. The prevalence of ventricular hypertrophy is increased in patients with diabetes mellitus, especially in the presence of renal involvement. Diabetic patients with renal involvement and cardiac hypertrophy have also been shown to have an increased risk for developing cardiac complications and having an increased mortality rate. Thus these two risk factors are important in the prognosis of the diabetic patient. Follow-up of the diabetic patient should include careful examination for the presence of proteinuria, reduced renal function and left ventricular hypertrophy in the hope that treatment of these factors may reduce morbidity and mortality.

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Adverse effects of left ventricular hypertrophy in the reduction of endpoints in NIDDM with the angiotensin II antagonist losartan (RENAAL) study

Abstract: Aims/hypothesis: We explored the impact of baseline left ventricular hypertrophy (LVH) and losartan treatment on renal and cardiovascular (CV) events in 1,513

Cited by 41 publications

References 45 publications

Impact of Left Ventricular Hypertrophy on the Time-Course of Renal Function in Hypertensive Patients - A Subanalysis of the CASE-J Trial -

Impact of Left Ventricular Hypertrophy on the Time-Course of Renal Function in Hypertensive Patients - A Subanalysis of the CASE-J Trial -

Diabetic Cardiomyopathy: Cardiac Changes, Pathophysiological Mechanisms, Biologic Markers, and the Available Therapeutic Armamentarium

Renal involvement and left ventricular hypertrophy are novel risk factors for morbidity and mortality in diabetes mellitus

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