Nav: Home

Blood pressure medications reduce stroke and heart attack in peritoneal dialysis patients

June 14, 2016

LOS ANGELES - (June 14, 2016) - Two classes of blood pressure medications, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), are associated with a 16% lower risk of strokes, heart attacks and death in patients with end-stage renal disease who are undergoing peritoneal dialysis, a new study in the journal, Nephrology Dialysis Transplantation, reports.

Researchers examined the medical records of 4,879 patients in the U.S. who began peritoneal dialysis between 2007 and 2011, and found 42% of them filled prescriptions for one of the two blood pressure medications, ACEIs or ARBs. The researchers then reviewed the outcomes and discovered the reduced risk of heart attacks, strokes and death among the group that had filled prescriptions for the blood pressure medications.

"While randomized clinical trials are needed to test whether this is a causal relationship, these findings indicate doctors should consider using or re-starting ACEIs and ARBs as first-line blood pressure medications for patients undergoing peritoneal dialysis," said Jenny I. Shen, MD, an LA BioMed researcher and corresponding author of the study. "These medications are often stopped when patients are in the late, but pre-dialysis, stages of kidney disease because of the risk of dangerously high potassium levels. The risk of higher potassium levels is minimized after patients have transitioned to peritoneal dialysis, but doctors often don't resume the medication even though it can usually be re-started safely."

The researchers reported that patients with end-stage renal disease face a greater risk of cardiovascular disease than healthy patients. Mortality exceeds 20% in the ?rst year after the initiation of dialysis, and 42% of these deaths are attributed to cardiovascular causes.

In patients with chronic kidney disease who are not on dialysis, ACEIs and ARBs slow the progression of diabetic nephropathy and reduce cardiovascular risk. Previous studies of their effectiveness in patients with end-stage renal disease produced mixed results, leading researchers to conduct the review of records of all U.S. patients who had initiated peritoneal dialysis from 2007 to 2011.

The researchers noted that while the use of ACEI and ARB was common among dialysis patients, it was "not as high as it could be, judging by the prevalence of hypertension and the use of other anti-hypertensives in nonusers."
The other researchers for this study were: Anjali B. Saxena, Maria E. Montez-Rath, Tara I. Chang and Wolfgang C. Winkelmayer from the Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA. Winkelmayer is also affiliated with the Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX.

This work was supported by NIDDK Grant Nos. F32DK096765, K23DK103972 and K23DK095914. The Stanford Nephrology fellowship program was supported by Grant No. T32DK007357. Dr. Shen was also supported by the Satellite Dialysis Clinical Investigator Award from the National Kidney Foundation, Grant No. KL2TR000122, from the National Institutes of Health/National Center for Advancing Translational Science and a generous gift honoring the life and work of nephrologist Henry Shavelle, M.D.

About LA BioMed

Founded in 1952, LA BioMed is one of the country's leading nonprofit independent biomedical research institutes. It has approximately 100 principal researchers conducting studies into improved diagnostics and treatments for cancer, inherited diseases, infectious diseases, illnesses caused by environmental factors and more. It also educates young scientists and provides community services, including prenatal counseling and childhood nutrition programs. LA BioMed is academically affiliated with the David Geffen School of Medicine at UCLA and located on the campus of Harbor-UCLA Medical Center. For more information, please visit

LA BioMed

Related Cardiovascular Disease Articles:

Is educational attainment associated with lifetime risk of cardiovascular disease?
Men and women with the lowest education level had higher lifetime risks of cardiovascular disease than those with the highest education level, according to a new study published by JAMA Internal Medicine.
Food policies could lower US cardiovascular disease rates
New research conducted by the University of Liverpool and partners shows that food policies, such as fruit and vegetable subsidies, taxes on sugar sweetened drinks, and mass media campaigns to change dietary habits, could avert hundreds of thousands of deaths from cardiovascular disease (CVD) in the United States.
Cardiovascular disease causes one-third of deaths worldwide
Cardiovascular diseases (CVD), including heart diseases and stroke, account for one-third of deaths throughout the world, according to a new scientific study that examined every country over the past 25 years.
Kidney disease is a major cause of cardiovascular deaths
In 2013, reduced kidney function was associated with 4 percent of deaths worldwide, or 2.2 million deaths.
Cardiovascular disease costs will exceed $1 trillion by 2035
A new study projects that by 2035, cardiovascular disease, the most costly and prevalent killer, if left unchecked, will place a crushing economic and health burden on the nation's financial and health care systems.
Prescribing drugs for cardiovascular disease prevention in the UK
Drugs such as statins that have the potential to prevent strokes and other types of cardiovascular disease have not been prescribed to a large proportion of people at risk in the UK, according to a research article by Grace Turner of the University of Birmingham, Birmingham, UK and colleagues published in PLOS Medicine.
Fatty liver disease contributes to cardiovascular disease and vice versa
For the first time, researchers have shown that a bi-directional relationship exists between fatty liver disease and cardiovascular disease.
More dietary calcium may lower risk of cardiovascular disease
In older people, higher dietary calcium intake may lower the risk of cardiovascular disease, but not of stroke and fracture, new research from South Korea suggests.
Renal hemodynamics and cardiovascular function in health and disease
The SRC will focus on unpublished work that is state-of-the-art in study of cardiovascular and renal disease and hypertension.
Cardiovascular disease in adult survivors of childhood cancer
For adult survivors of childhood cancer, cardiovascular disease presents at an earlier age, is associated with substantial morbidity, and is often asymptomatic.

Related Cardiovascular Disease Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Jumpstarting Creativity
Our greatest breakthroughs and triumphs have one thing in common: creativity. But how do you ignite it? And how do you rekindle it? This hour, TED speakers explore ideas on jumpstarting creativity. Guests include economist Tim Harford, producer Helen Marriage, artificial intelligence researcher Steve Engels, and behavioral scientist Marily Oppezzo.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".