Consider The Evidence: Med/Peds Journal Roundup

February 1, 2006

Connecting GFR to Cardiovascular Outcomes: ALLHAT

Filed under: annals of internal medicine, cardiovascular, hypertension, renal — medblog @ 2:45 am

Annals 2/7 – Picking apart two frequently co-morbid diagnoses, Rahman et al. propose that low GFR is an independent predictor for CVD in hypertensive patients. In fact, patients with a moderate to severe reduction in GFR had a higher 6-year incidence of developing CHD than ESRD.

They also report that amlodipne is less effective than the diuretic chlorthalidone in preventing CHD, and lisinopril is less effective than chlorthalidone in preventing heart failure. (Why they used this wierd drug instead of HCTZ is still beyond me). ALLHAT has come up big for the old diuretic therapy. But I’m not ready to drop the positive data on ACE-Is (HOPE data especially) until the dust settles on this issue.

Cardiovascular Outcomes in High-Risk Hypertensive Patients Stratified by Baseline Glomerular Filtration Rate.
Rahman, Mahboob MD, MS; Pressel, Sara MS; Davis, Barry R. MD, PhD; Nwachuku, Chuke MA, MPH, DrPH; Wright, Jackson T. Jr., MD, PhD; Whelton, Paul K. MD, MSc; Barzilay, Joshua MD; Batuman, Vecihi MD; Eckfeldt, John H. MD, PhD; Farber, Michael A. MD; Franklin, Stanley MD; Henriquez, Mario MD; Kopyt, Nelson DO; Louis, Gail T. RN; Saklayen, Mohammad MD; Stanford, Carole MD; Walworth, Candace MD; Ward, Harry MD; Wiegmann, Thomas MD; for the ALLHAT Collaborative Research Group

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