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Optimizing outcomes in patients with cardiovascular disease and chronic kidney disease.
Am J Manag Care. 2011 Dec; 17 Suppl 15:S403-11.AJ

Abstract

Chronic kidney disease (CKD) is an independent risk factor for the development of cardiovascular disease (CVD). Often, CKD and CVD coexist, and patients warrant optimal pharmacotherapy to reduce the risk of future cardiovascular (CV) events. Randomized trials have evaluated the role of antihypertensive therapy and lipid-lowering therapy as means to reduce CVD in patients with CKD. Many clinical trials support the role of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in the CKD population. In addition, many clinical trials have evaluated the role of statin therapy in reducing CV events in early- and late-stage CKD. The struggle with interpreting results from these trials is that there are a number of different CV composite end points and a lack of consistency in defining CKD, especially in some post hoc subanalyses. Overall, ACEI/ARB therapy is supported by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) hypertension guidelines and statin therapy is supported by the Adult Treatment Panel (ATP) III and NKF KDOQI dyslipidemia guidelines to optimally manage patients with CKD and CV risk factors. Questions remain as to the optimal role of statin therapy in patients with CKD receiving dialysis. JNC 8 and ATP IV guidelines will be available in the next year, and it is expected that there will be specific recommendations on both hypertension and dyslipidemia management in the CKD population.

Authors+Show Affiliations

University of Colorado, Anschutz Medical Campus, School of Pharmacy, Aurora, CO, USA. joel.marrs@ucdenver.edu

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22214475

Citation

Marrs, Joel C.. "Optimizing Outcomes in Patients With Cardiovascular Disease and Chronic Kidney Disease." The American Journal of Managed Care, vol. 17 Suppl 15, 2011, pp. S403-11.
Marrs JC. Optimizing outcomes in patients with cardiovascular disease and chronic kidney disease. Am J Manag Care. 2011;17 Suppl 15:S403-11.
Marrs, J. C. (2011). Optimizing outcomes in patients with cardiovascular disease and chronic kidney disease. The American Journal of Managed Care, 17 Suppl 15, S403-11.
Marrs JC. Optimizing Outcomes in Patients With Cardiovascular Disease and Chronic Kidney Disease. Am J Manag Care. 2011;17 Suppl 15:S403-11. PubMed PMID: 22214475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimizing outcomes in patients with cardiovascular disease and chronic kidney disease. A1 - Marrs,Joel C, PY - 2012/1/5/entrez PY - 2012/1/5/pubmed PY - 2012/4/24/medline SP - S403 EP - 11 JF - The American journal of managed care JO - Am J Manag Care VL - 17 Suppl 15 N2 - Chronic kidney disease (CKD) is an independent risk factor for the development of cardiovascular disease (CVD). Often, CKD and CVD coexist, and patients warrant optimal pharmacotherapy to reduce the risk of future cardiovascular (CV) events. Randomized trials have evaluated the role of antihypertensive therapy and lipid-lowering therapy as means to reduce CVD in patients with CKD. Many clinical trials support the role of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in the CKD population. In addition, many clinical trials have evaluated the role of statin therapy in reducing CV events in early- and late-stage CKD. The struggle with interpreting results from these trials is that there are a number of different CV composite end points and a lack of consistency in defining CKD, especially in some post hoc subanalyses. Overall, ACEI/ARB therapy is supported by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) hypertension guidelines and statin therapy is supported by the Adult Treatment Panel (ATP) III and NKF KDOQI dyslipidemia guidelines to optimally manage patients with CKD and CV risk factors. Questions remain as to the optimal role of statin therapy in patients with CKD receiving dialysis. JNC 8 and ATP IV guidelines will be available in the next year, and it is expected that there will be specific recommendations on both hypertension and dyslipidemia management in the CKD population. SN - 1936-2692 UR - https://www.unboundmedicine.com/medline/citation/22214475/Optimizing_outcomes_in_patients_with_cardiovascular_disease_and_chronic_kidney_disease_ L2 - https://www.ajmc.com/pubMed.php?pii=53185 DB - PRIME DP - Unbound Medicine ER -