Antihypertensive Agents Found to Slow GFR Decline
A comparison of 12,411 American veterans using antihypertensive drugs and another 13,406 with elevated BP who were not taking antihypertensive drugs showed that those on medication had higher glomerular filtration rates (GFRs). The investigators also found that the GFRs of those with uncontrolled BP fell more steeply.
The findings were presented in a poster here at the International Society of Pharmacoeconomics and Outcomes Research's 2008 annual meeting.
“It provides more evidence that blood pressure control with medication preserves kidney function over time, and that the longer the medication is taken, the better preservation there is,” noted lead investigator Karen Smith, PhD, a postdoctoral research fellow in the
Dr. Smith, who performed the analysis as part of her doctoral thesis, obtained the data from the Southern Arizona Veterans' Affairs Health Care System database, using records from January 1, 2000, to December 31, 2006. She analyzed the records of veterans diagnosed with hypertension.
The veterans in the controlled-BP group were significantly older than those with uncontrolled BP, at an average of 66.6 and 64.9 years, respectively, but the GFR values and CKD stages were similarly distributed.
Dr. Smith and her colleagues found that GFRs in all subjects decreased over time, and were lower in the older veterans. All of the antihypertensive medications the veterans were taking—ACE inhibitors, calcium channel blockers (CCB), and beta blockers (BB)—were associated with lower GFRs and slower declines in GFR than were observed in hypertensive veterans not taking these medications.
ACE inhibitors appeared to have the strongest effects, and Dr. Smith said the data suggest that these agents are superior to CCB and BB. Data show no difference between these two classes of drugs.