Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial

Ruggenenti, Piero; Perna, Annalisa; Loriga, Giacomina; Ganeva, María; Ene-Iordache, Bogdan; Turturro, Marta; Lesti, Mariadomenica; Perticucci, Elena; Chakarski, Ivan Nediyalkov; Leonardis, Daniela; Garini, G; Sessa, A.; Basile, Carlo; Alpa, Mirella; Scanziani, Renzo; Sorba, Gianbattista; Zoccali, Carmine; Remuzzi, Giuseppe

doi:10.1016/s0140-6736(05)71082-5

Cited by 578 publications

(297 citation statements)

References 33 publications

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“…The authors concluded that the CCB provided no incremental benefit for patients already receiving the ACE inhibitor despite improved BP control. 88 However, because this was a relatively small study and had a limited follow-up period, the data must be interpreted with caution.…”

Section: Clinical Evidence Of Benefits Of Raas Inhibition In Non-diabmentioning

confidence: 92%

“…43,50,[81][82][83][84][85][86][87][88] In a placebo-controlled trial, 3 years of benazepril therapy reduced the risk of the primary composite end point (doubling of serum creatinine or need for dialysis) by 53% compared with placebo (Po0.001). 50 A greater risk reduction was seen in patients with mild renal insufficiency (71%) compared with patients with moderate renal insufficiency (46%).…”

Section: Clinical Evidence Of Benefits Of Raas Inhibition In Non-diabmentioning

confidence: 99%

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Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

Karalliedde

Viberti

2006

J Hum Hypertens

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The incidence of end-stage renal disease (ESRD) is rising worldwide, accompanied by corresponding increases in the risk of morbidity and mortality. Underlying this trend are increasing rates of hypertension and diabetes mellitus, the two most common causes of ESRD. In addition to the adverse haemodynamic effects of hypertension on the kidney, elevated blood pressure (BP) can activate components of the renin-angiotensinaldosterone system (RAAS), which, in turn, activate mediators of inflammation, oxidative stress, cell growth, and matrix accumulation. Lowering BP reduces the risk of cardiovascular events and renal damage. Accumulating evidence from clinical and laboratory studies suggests that interrupting the RAAS with therapies such as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and aldosterone receptor blockers can interfere with the mechanisms that promote diabetic and non-diabetic renal damage. Moreover, clinical trials of RAAS blockade have demonstrated reductions in microalbuminuria, a predictor of increased cardiorenal risk and overt nephropathy in patients with and without diabetes and/or hypertension. In this way, agents that block the RAAS should be considered the drugs of first choice as they provide enhanced renoprotection compared with other classes of antihypertensive agents such as calcium channel blockers and b-blockers.

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Section: Clinical Evidence Of Benefits Of Raas Inhibition In Non-diabmentioning

confidence: 92%

Section: Clinical Evidence Of Benefits Of Raas Inhibition In Non-diabmentioning

confidence: 99%

Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

Karalliedde

Viberti

2006

J Hum Hypertens

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“…The evidence for these recommendations is based on 3 trials—the African American Study of Kidney Disease and Hypertension (AASK), the Modification of Diet in Renal Disease (MDRD) study, and the Blood‐pressure Control for Renoprotection in Patients with Non‐diabetic Chronic Renal Disease (REIN‐2) study. None of these trials showed a difference in kidney or CVD outcomes between those with lower versus higher BP goals 40, 41, 42…”

Section: Jnc 8 Recommendations 2 Tomentioning

confidence: 99%

US Hypertension Management Guidelines: A Review of the Recent Past and Recommendations for the Future

Kovell

Ahmed

Misra

et al. 2015

JAHA

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“…Citing a paucity of evidence that a goal of 130/80 mm Hg in patients with CKD is associated with improved outcomes,46, 47, 48 the Joint National Committee 8 panel recommended that all patients 18 years and older with CKD or diabetes should have a BP goal of <140/90 mm Hg,19 rather than the prior target of 130/80 mm Hg 6. Our finding of no interaction between CKD or diabetes mellitus and BP and the limited availability of randomized controlled trial data highlights the importance of future randomized trials addressing the optimal BP target in individuals with multiple comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

Associations Between Blood Pressure and Outcomes Among Blacks in the Jackson Heart Study

Randolph

Greiner

Egwim

et al. 2016

JAHA

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BackgroundIn 2014, new hypertension guidelines liberalized blood pressure goals for persons 60 years and older. Little is known about the implications for blacks.Methods and ResultsUsing data from 2000 through 2011 for 5280 participants in the Jackson Heart Study, a community‐based black cohort in Jackson, Mississippi, we examined whether higher blood pressure was associated with greater risk of mortality and heart failure hospitalization, and whether the risk was the same across age groups. We investigated associations between baseline blood pressure and both mortality and heart failure hospitalization. We also tested for interactions between age and blood pressure in the mortality model. Median systolic and diastolic blood pressures at baseline were 125 mm Hg (25th–75th percentile, 114–137 mm Hg) and 79 mm Hg (72–86 mm Hg), respectively. Median follow‐up was 9 years for mortality and 7 years for heart failure hospitalization. After multivariable adjustment, every 10 mm Hg increase in systolic blood pressure was associated with greater risks of mortality (hazard ratio, 1.12; 95% CI, 1.06–1.17) and heart failure hospitalization (1.07; 95% CI, 1.00–1.14). The mortality risk per 10 mm Hg increase in systolic blood pressure was greater in participants younger than 60 years (1.26; 95% CI, 1.13–1.42) than among participants 60 years and older (1.09; 95% CI, 1.03–1.15).ConclusionsAdults in all age groups were at greater risk of mortality as systolic blood pressure increased. In the context of the 2014 hypertension guidelines, these findings should be considered when determining treatment goals in black patients.

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Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial

Cited by 578 publications

References 33 publications

Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes

US Hypertension Management Guidelines: A Review of the Recent Past and Recommendations for the Future

Associations Between Blood Pressure and Outcomes Among Blacks in the Jackson Heart Study

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