Kidney Patients Staying Heart Healthy

Blood pressure management reduced the risk of heart problems for people with and without kidney disease

(RxWiki News) People who have kidney disease should take care of another crucial organ: the heart. A recent review looked at the effects of lowering blood pressure on heart health for people who suffer from kidney disease.

People with kidney disease have a higher risk of also developing heart disease. To see how this risk can be lessened, researchers examined 25 trials on blood pressure and heart health, paying special attention to participants who showed symptoms of kidney disease.

They found that lower blood pressure was linked to lower rates of stroke, heart attack and other heart problems for people with and without kidney disease.

The researchers said that the findings show the importance of managing blood pressure to reduce the risk of heart problems. They suggested that, because people with kidney disease are at an increased risk for heart disease, they would benefit from keeping their blood pressure in a normal range.

"If you have kidney disease, talk to your doctor about maintaining a healthy blood pressure."

Vlado Perkovic of the George Institute for Global Health in the University of Sydney analyzed previous trials to see how lowering blood pressure affected heart health in people with chronic kidney disease.

Kidney disease is characterized by kidneys' reduced ability to filter waste from the blood. According to the researchers, it is associated with a risk of kidney failure and heart disease, making heart health crucially important for people who suffer from kidney disease. Also, people with kidney disease often have higher blood pressure than people with fully functioning kidneys.

For the review of previous research, the researchers included medical trials that had already been conducted on the affect of blood pressure lowering drugs and heart health for people with and without kidney disease.

Each trial had to include either a control group with a placebo (fake medicine) or different groups with different types of blood pressure drugs.

Altogether, the authors of the review included 25 trials that used 152,290 participants. Some of the trials tested ACE inhibitors, which is a class of medications that prevents blood vessels from constricting. Others tested calcium antagonists, which change calcium movement in the body in order to work against stiff vessels. 

The researchers looked at each trial to see how many participants suffered from a stroke, coronary heart disease, heart failure, cardiovascular death, and overall death.

They recorded the effects that the blood pressure medicine or placebo had on the participants' blood pressure throughout the duration of the trial. They also looked at the kidney's ability to filter waste, when the information was available.

The researchers found that reducing blood pressure helped prevent negative heart health outcomes.

The benefits were the same in people with and without chronic kidney disease. However, the authors of the study note that people with kidney disease have much more to gain from reduced blood pressure because their risk of poor heart health is higher.

The researchers found that, in the studies with ACE inhibitors, the medication reduced the risk of negative heart-related events like heart attack and stroke by one-sixth. The researchers also concluded that the data didn't present clear evidence for favoring one drug over another.

The authors of the study noted that their conclusions are somewhat limited, because each study did not thoroughly examine patients' kidney health. However, given the positive benefits of lower blood pressure for participants with kidney disease and the amount of trial participants, the report shows evidence of the importance of managing blood pressure for heart health.

The study was published in BMJ on October 3.

The project was funded by the National Health and Medical Research Council of Australia. Some of the authors reported receiving honoraria and research support from pharmaceutical companies.

Review Date: 
October 15, 2013