Impact of left ventricular hypertrophy on the time-course of renal function in hypertensive patients: A subanalysis of the CASE-J trial

Abstract

Background: In this subanalysis of the CASE-J, which was conducted to compare the effects of candesartan and amlodipine in Japanese high-risk hypertensive patients, the association of left ventricular hypertrophy (LVH) with renal function is clarified. Methods and Results: Patients were divided into 2 groups: 1,082 patients with LVH and 2,119 patients without LVH. The primary endpoint was the change in the estimated glomerular filtration rate (eGFR). The eGFRs were increased from 63.6 to 65.1 ml · min-1 · 1.73 m-2 in patients with LVH and from 63.6 to 68.5 ml · min-1 · 1.73 m-2 in those without LVH. The improvement in the eGFR was greater in patients without LVH than in those with LVH (P=0.004). In patients with chronic kidney disease (CKD) patients, the eGFR increased from 52.7 to 60.5 ml · min-1 · 1.73 m-2 in patients without LVH, but from 53.1 to 57.2 ml · min-1 · 1.73 m-2 in those with LVH (P<0.001, patients without LVH vs patients with LVH). Furthermore, because the eGFR changed from 76.5 to 75.4 ml · min-1 · 1.73 m-2 in patients without CKD but with LVH, and from 76.5 to 77.5 ml · min-1 · 1.73 m-2 in those without either CKD or LVH, the final eGFR was higher in patients without LVH than in those with LVH (P=0.048). Conclusions: LVH related to the time-course of renal function in Japanese hypertensive patients.