Diuretics are preferred first-line over CCBs to optimize reduction of cardiovascular events .
The review does not distinguish between CCBs , ACE inhibitors or ARBs , but does provide evidence supporting the use of CCBs over beta-blockers .
BACKGROUND Calcium channel blockers ( CCBs ) are a relatively new antihypertensive class .
The effect of first-line CCBs on the prevention of cardiovascular events , as compared with other antihypertensive drug classes , is unknown .
OBJECTIVES To determine whether CCBs used as first-line therapy for hypertension are different from other first-line drug classes in reducing the incidence of major adverse cardiovascular events .
The Irbesartan type II diabetic nephropathy trial: study design and baseline patient characteristics. For the Collaborative Study Group.
BACKGROUND Diabetic nephropathy is the most common cause of end-stage renal disease in the developed world . Angiotensin-converting enzyme inhibitors have been demonstrated to be renoprotective in type I diabetes and are now the st and ard of care for both hypertensive and non-hypertensive type I diabetic patients with any level of proteinuria . The role of blockade of the renin-angiotensin system in type II diabetic patients is not defined . The Collaborative Study Group has initiated the Irbesartan Type II Diabetic Nephropathy Trial ( IDNT ) , study ing the effect of the angiotensin II receptor antagonist irbesartan on progression of renal disease and mortality in type II diabetic patients with overt nephropathy and hypertension . Here we report the study design and baseline patient characteristics . METHODS To qualify , hypertensive type II patients , age 30 - 70 years , must have a 24 h urinary protein excretion of > 900 mg and a serum creatinine 90 - 265 micromol/l ( 1.0 - 3 . 0 mg/dl ) in women and 110 - 265 micromol/l ( 1.2 - 3.0 mg/dl ) in men . Three treatment arms include irbesartan , placebo and amlodipine , with every attempt made to achieve similar blood pressure levels in all treatment arms . A total of 1650 patients will be enrolled utilizing approximately 225 clinics worldwide . The primary outcome measure is time to event to the composite end-point of doubling of serum creatinine , end-stage renal disease or death . The secondary outcome measure is time to composite end-point of fatal or non-fatal cardiovascular events . The average length of patient follow-up is expected to be approximately 36 months . RESULTS The baseline characteristics of the study subjects are : age 59+/-8 years , duration of diabetes 15+/-9 years , height 168+/-11 cm ( 5 ft 6 in ) , weight 87+/-19 kg ( 192 lb ) , body mass index 31+/-7 kg/m(2 ) , blood pressure 156+/-18 mmHg/85+/-11 mmHg , serum creatinine 150+/-53 micromol/l ( 1.7+/-0.6 mg/dl ) , creatinine clearance 66+/-34 ml/min and 24 h urine protein 4.0+/-3.5 g/day
Diuretics are preferred first-line over CCBs to optimize reduction of cardiovascular events .
The review does not distinguish between CCBs , ACE inhibitors or ARBs , but does provide evidence supporting the use of CCBs over beta-blockers .
BACKGROUND Calcium channel blockers ( CCBs ) are a relatively new antihypertensive class .
The effect of first-line CCBs on the prevention of cardiovascular events , as compared with other antihypertensive drug classes , is unknown .
OBJECTIVES To determine whether CCBs used as first-line therapy for hypertension are different from other first-line drug classes in reducing the incidence of major adverse cardiovascular events .