Amlodipine treatment may reduce cardiovascular risks in hypertensive hemodialysis patients, according to German researchers.
In a prospective study, Martin Tepel, MD, of Charité Campus Benjamin Franklin in Berlin, and his colleagues evaluated the effects of amlodipine on cardiovascular events in 251 hypertensive hemodialysis patients (median age 61 years). They randomly assigned 123 patients to receive amlodipine (10 mg once daily) and 128 to receive placebo.
The primary end point was death from any cause. A secondary end point was a composite of all-cause mortality or cardiovascular event (MI, need for coronary angioplasty, coronary bypass surgery, ischemic stroke, or peripheral vascular disease with the need for amputation or angioplasty).
After a median follow-up of 19 months, amlodipine treatment was associated with a significant decrease in systolic, but not diastolic, BP. Death from any cause occurred in 15 patients (12%) in the amlodipine group and 22 (17%) in the placebo group, a non-significant difference between the groups, the investigators reported in Nephrology Dialysis Transplantation (2008;23:3605-3612).
The composite end point of all-cause mortality or a cardiovascular event occurred in 19 amlodipine-treated patients (15%) and 32 placebo recipients (25%), a significant difference that translated into a 47% decreased risk of the composite end point.