Enhanced Cardiovascular Protective Effects of Valsartan in High-Risk Hypertensive Patients With Left Ventricular Hypertrophy : Sub-Analysis of the KYOTO HEART Study
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概要
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Background: The objective of the present study was to examine whether baseline electrocardiographically diagnosed left ventricular hypertrophy (ECG-LVH) influenced the angiotensin II receptor blocker (ARB) valsartan add-on effects on the cardio-cerebrovascular morbidity and mortality in the high-risk hypertensive patients who participated in the KYOTO HEART Study. Methods and Results: The primary endpoint was the same as in the main study: a composite of defined cardiovascular and cerebrovascular events. The median follow-up period was 3.27 years. The study group was divided into 2 groups according to the presence of ECG-LVH: with LVH, n=803; without LVH, n=2,228. The primary endpoint events occurred more frequently in patients with LVH than in patients without LVH (9.3% vs. 7.3%; hazard ratio [HR], 1.33; 95% confidence interval [CI]: 1.01-1.75). Valsartan add-on significantly decreased the occurrence of primary endpoint events in both LVH-positive patients (5.8% vs. 12.9%; HR, 0.45; 95%CI: 0.28-0.72) and LVH-negative patients (5.5% vs. 9.2%; HR, 0.59; 95%CI: 0.44-0.81) compared with non-ARB treatment. The reduction in combined cardiovascular events (composite of acute myocardial infarction, angina pectoris, and heart failure) due to valsartan treatment in patients with LVH was significantly larger than that in patients without LVH (P<0.0001). Changes in blood pressure during the follow-up period did not differ significantly among the study subgroups. Conclusions: High-risk hypertensive patients with ECG-LVH might gain more cardiovascular benefits from valsartan add-on treatment, compared with patients without ECG-LVH. (Circ J 2011; 75: 806-814)
- 2011-03-25
著者
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Hori Masatsugu
大阪大学 医学系研究科循環器内科学
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Sawada Takahisa
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
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Matsubara Hiroaki
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
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Hoshikawa Yoshiko
Div. Of Molecular And Genetic Medicine Dep. Of Genetic Medicine And Regenerative Therapeutics Gradua
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Muratani H
Department Of Clinical Pharmacology And Therapeutics Tohoku University
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Shiraishi Jun
Department of Cardiology, Kyoto First Red Cross Hospital
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Kimura Shinzo
AMI-Kyoto Multi-Center Risk Study Group
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YAMADA Hiroyuki
Department of Materials Engineering, Graduate school of Engineering, The University of Tokyo
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Yamada Hiroyuki
Ami-kyoto Multi-center Risk Study Group
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Yasue H
Kumamoto Univ. School Of Medicine
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Hirata Yasunobu
Cardiovascular Medicine University Of Tokyo
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Makino Hirofumi
岡山大学 医歯学総合研究科腎･免疫･内分泌代謝内科学
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Makino H
Department Of Medicine And Clinical Science Okayama University Graduate School Of Medicine And Denti
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Makino Hirofumi
大阪大学 医学系研究科老年･腎臓内科学
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Matsuoka Hiroaki
大阪大学 医学系研究科老年･腎臓内科学
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Masaki Hiroya
The Cardiovascular Center Kansai Medical University
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Matsubara Hiroaki
公立南丹病院 循環器内科
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Hori Masatsugu
大阪大学 大学院医学系研究科内科系臨床医学専攻核医学講座
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Matsubara Hiroaki
京都府立医科大学 循環器内科学
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Yokoi Hirokazu
Department Of Cardiovascular Medicine Kyoto Prefectural University School Of Medicine
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Matsuo H
Department Of Internal Medicine Circulatory And Body Fluid Regulation Faculty Of Medicine University
-
Hirata Yasunobu
Department Of Cardiovascular Medicine The University Of Tokushima
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Hirata Yasunobu
東京大学 第2内科
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Horio Masaru
琉球大学医学部附属病院 血液浄化療法部
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Horio Masaru
大阪大学 医学系研究科内科学講座腎臓内科
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Tanaka Shiro
大阪市立総合医療センター
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Tanaka Shiro
Department Of Internal Medicine Osaka City General Hospital
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Hoshikawa Yoshiko
鳥取大学 医学系研究科遺伝子医療学
-
Takai Shinji
Department Of Cardiology Kouseikai Takeda Hospital
-
Yokote Hiroyuki
The Chemo-Sero-Therapeutic Research Institute
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Shiraishi Jun
Department Of Cardiology Kyoto First Red Cross Hospital
-
Horio Masaru
大阪大学 医学系研究科老年･腎臓内科学
-
Yasue H
Division Of Molecular And Genetic Medicine Department Of Genetic Medicine And Regenerative Therapeut
-
Matsubara Hiroaki
京都第一赤十字病院 循環器科
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Matsubara Hiroaki
Department Of Cardiology Kyoto Prefectural University Of Medicine
-
Muratani Hiromi
琉球大学 第3内科
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Muratani H
Univ. Rykyus School Of Medicine Okinawa Jpn
-
Metoki Hirohito
東北大学 臨床薬学
-
Metoki Hirohito
Department Of Clinical Pharmacology And Therapeutics Tohoku University Graduate School Of Pharmaceut
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Kimura Shinzo
Department of Cardiology, Kyoto prefectural Yosanoumi Hospital
-
Manabe Hisao
Department of Cardiovascular Surgery National Cardiovascular Center
-
Hori Masatsugu
Department Of Cardiology Osaka University Graduate School Of Medicine
-
Kato Tomoko
国立循環器病研究センター 心臓血管内科部門
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Mani Hiroki
The Second Department Of Medicine Kyoto Prefectural University Of Medicine
-
Sawada Takahisa
京都第一赤十字病院 循環器科
-
Maeba Hirofumi
Cardiovascular Center Kansai Medical University
-
Horio M
Department Of Clinical Pharmacology And Therapeutics Tohoku University Graduate School Of Pharmaceut
-
Harada Masaki
Department Of Medicine And Clinical Science Kyoto University Graduate School Of Medicine
-
Takai Shinji
Department Of Pharmacology Osaka Medical College
-
Shirayama Takeshi
Second Department Of Medicine Kyoto Prefectural University Of Medicine
-
YAMABE Hideaki
Hirosaki University School of Medicine
-
Makino Hirofumi
The Department Of Medicine Iii Okayama University Medical School
-
Mani Hiroki
Department Of Clinical Molecular Genetics And Laboratory Medicine Kyoto Prefectural University Of Me
-
Horiuchi Masatsugu
Department Of Medical Biochemistry 1 Ehime University School Of Medicine
-
HIRAI Masashi
the National Minami Fukuoka Chest Hospital
-
Haneda Masakazu
Asahikawa Medical Coll. Asahikawa Jpn
-
Haneda Masakazu
Division Of Metabolism And Biosystemic Science Asahikawa Medical College
-
Mashiba Hiroto
Kure Kyosai Hospital
-
Matsubara Hiroaki
Department Of Cardiovascular Medicine Kyoto Prefectural University School Of Medicine
-
Matsuoka H
Kyoto Univ. Kyoto
-
Hiroi Yukio
Department Of Cardiovascular Medicine University Of Tokyo Graduate School Of Medicine
-
Takai Shinji
The First Department Of Internal Medicine Osaka Medical College
-
Matsuoka Hiroaki
Division Of Hypertension And Cardiorenal Disease Department Of Medicine Dokkyo University School Of
-
MATSUOKA Hiroaki
National Cardiovascular Center Research Institute
-
Matsuo Hisayuki
Department Of Internal Medicine Circulatory And Body Fluid Regulation Faculty Of Medicine University
-
Matsuoka Hiroaki
Department Of Hypertension And Cardiorenal Medicine Dokkyo Medical University
-
Yamada Hiroyuki
Department Of Cardiovascular Medicine Kyoto Prefectural University Of Medicine
-
Sawada Takahisa
Department Of Pharmacology Osaka Medical College
-
Miyoshi Hironori
The Second Department Ofinternal Medicine Kansai Medical University
-
Hori Masatsugu
Department Of Radiology National Center Hospital For Mental Nervous And Muscular Disorders National
-
Maeba Hirofumi
Division Of Cardiology Kansai Medical University
-
Hori Masatsugu
Division Of Cardiovascular Surgery Cardiovascular Medicine Osaka University Graduate School Of Medic
-
Hori Masatsugu
Department Of Nephrology Osaka University Graduate School Of Medicine
-
Shirayama Takeshi
The Second Department Of Medicine Kyoto Prefectural University Of Medicine
-
Hirose Makoto
The Department Of Nephrology And Cardiology International Medical Center Of Japan
-
Horio Masaru
Department Of Internal Medicine And Therapeutics Osaka University Graduate School Of Medicine (a8)
-
Miyakoda Hiroyuki
The First Department Of Internal Medicine Tottori University School Of Medicine
-
Matsui Hiroshi
Research Institute National Center Of Cardiovascular Medicine
-
Sawada Takahisa
Department Of Cardiovascular Medicine Heart Failure Division National Cerebral And Cardiovascular Ce
-
Matsuda Hiroto
Department Of Internal Medicine School Of Medicine Keio University
-
Hiroe Michiaki
Second Department Of Internal Medicine Tokyo Medical And Dental University
-
Mashiba Hiroto
The First Department Of Internal Medicine Tottori University School Of Medicine
-
Horio Masaru
Department Of Nephrology Osaka University Graduate School Of Medicine
-
Yasue Hirofumi
Department Of Cardiology Kumamoto City Hospital
-
Yasue Hirofumi
Department Of Cardiology Kumamoto University School Of Medicine
-
Maeba Hirofumi
2nd Department Of Internal Medicine Kansai Medical University
-
Matsuoka Hiroaki
2nd Dept. Of Int. Med. University Of Tokyo
-
Matsubara Hiroaki
Division Of Cardiology And Nephrology Department Of Medicine Kyoto Prefectural University Of Medicin
-
Hiroe Michiaki
Department Of Radiology Tokyo Women's Medical College
-
Yasue Hirofumi
Division Of Cardiovascular Medicine Kumamoto Kinoh Hospital Kumamoto Aging Research Institute
-
Hiroe Michiaki
Department Of Nephrology And Cardiology
-
Mastuoka Hiroaki
Department Of Hypertension And Cardiorenal Medicine Dokkyo Medical University School Of Medicine
-
Mani Hiroki
Department Of Cardiovascular Medicine Kyoto Prefectural University School Of Medicine
-
Horio Masaru
Division Of Health Sciences Department Of Functional Diagnostic Science Osaka University Graduate Sc
-
Shima Takatomo
Department Of Cardiology Kyoto First Red Cross Hospital
-
Yamabe Hiroshige
Division Of Cardiology Kumamoto City Hospital
-
Yoshimi Hiroki
Clinical Development Institute Banyu Pharmaceutical Co. Ltd.
-
Matsuo Hisayuki
Research Institute National Center Of Cardiovascular Medicine
-
Yokoyama Hitoshi
Division Of Nephrology Kanazwa Medical University
-
Miyazaki Hiroshi
Department Of Cardiology Kyoto First Red Cross Hospital
-
Mashiba Hiroto
Department Of Internal Medicine Tottori University School Of Medicine
-
Tanda Syuji
Division Of Hypertension And Nephrology Department Of Internal Medicine Kyoto Prefectural University
-
Higashikuni Yasutomi
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
-
Hirata Youichirou
Department Of Cardiovascular Medicine The University Of Tokushima
-
Shirayama Takeshi
Kyoto Prefectural University Of Medicine Department Of Cardiology
-
Masuyama Hiroyuki
Department Of Internal Medicine Circulatory And Body Fluid Regulation Faculty Of Medicine University
-
Manabe Hisao
1st Department Of Surgery Osaka University Medical School
-
Hirata Y
Department Of Cardiovascular Medicine University Of Tokyo Graduate School Of Medicine
-
Mashiba Hiroto
The 1st Dept. Intern. Med. Tottori Univ. School Of Med
-
Makino Hirofumi
International Medical Center Of Japan
-
Kimura Shinzo
Department Of Cardiology Kyoto Prefectural Yosanoumi Hospital
-
Higuchi Masayoshi
Department Of Geriatric Medicine Osaka University Graduate School Of Medicine
-
Matsuoka Hiroaki
Department Of Medicine Division Of Hypertension And Cardiorenal Disease Dokkyo University School Of
-
Matsuoka Hiroaki
Division Of Hypertension And Renal Diseases Department Of Medicine National Cardiovascular Center Ho
-
Haneda Masakazu
Department Of Functional Diagnostic Science Course Of Health Science Osaka University Graduate Schoo
-
Sawada Takahisa
Department Of Cardiology Tokyo Medical And Dental University
-
Miyoshi Hironori
Cardiovascular Division Department Of Medicine Ii Kansai Medical University
-
Hori Masatsugu
大阪府立成人病センター
-
Yoshimi Hiroki
Division Of Molecular And Genetic Medicine Department Of Genetic Medicine And Regenerative Therapeut
-
Sawada Takahisa
Department Of Cardiology Kyoto First Red Cross Hospital
-
Hiroe Michiaki
International Cardiomyopathy Study Section Japan Research Promotion Society For Cardiovascular Disea
-
Matsui Hiroyuki
Second Department Of Medicine Kyoto Prefectural University Of Medicine
-
Yamabe Hiroshige
Department Of Cardiology Kumamoto City Hospital
-
Yamada Hiroyuki
Department Of Anatomy School Of Dentistry Aichi-gakuin University
-
Mani Hiroki
Department Of Clinical Molecular Genetics And Laboratory Medicine Kyoto Prefectural University Of Me
-
Yamaguchi Hiroshi
The Department Of Cardiology Juntendo University School Of Medicine
-
Hiroe Michiaki
International Cardiomyopathy Study Section Japan Research Promotion Society For Cardiovascular Disea
-
Tanda Syuji
Department Of Cardiology Kouseikai Takeda Hospital
-
Hattori Motoshi
Department Of Pediatric Nephrology Tokyo Women's Medical University School Of Medicine
-
Matsubara Hiroaki
Department Of Bioscience National Cardiovascular Center Research Institute
-
Masugata Hisashi
香川大学 内科学
-
Hirata Yasunobu
Department Of Cardiology Tokyo University
-
Matsuura Hideo
Department Of Internal Medicine Saiseikai Kure Hospital
-
Hirata Yasunobu
The Departments Of Cardiovascular Medicine Faculty Of Medicine University Of Tokyo
-
Haneda Masakazu
大阪大学 検査情報学
-
Tanaka Shiro
The Department Of Internal Medicine Osaka City General Hospital
-
Hoshikawa Yoshiko
Division Of Molecular And Genetic Medicine Department Of Genetic Medicine And Regenerative Therapeutics Graduate School Of Medicine Tottori University
-
Sawada Takahisa
Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
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- Elevated Brachial-Ankle Pulse Wave Velocity Is Associated with Left Ventricular Hypertrophy in Hypertensive Patients after Stroke
- PJ-530 Fasting Serum Phosphate Level : A Potential Marker of Visceral, but not Subcutaneous, Fat Area(Kidney/Renal circulation(07)(H),Poster Session(Japanese),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- Usefulness of assessing masked and white-coat hypertension by ambulatory blood pressure monitoring for determining prevalent risk of chronic kidney disease : the Ohasama study
- Left Ventricular Assist System Through the Left Ventricle for Acute Myocardial Infarction : Report of a Case
- Clinical manifestations and effects of primary percutaneous coronary intervention for patients with delayed pre-hospital time in acute myocardial infarction
- Association between Bone Mineral Density and Arterial Stiffness in Hypertensive Patients
- Comparison of a simple and a standard method for inulin renal clearance
- Enhanced Cardiovascular Protective Effects of Valsartan in High-Risk Hypertensive Patients With Left Ventricular Hypertrophy : Sub-Analysis of the KYOTO HEART Study
- Association between High-Sensitivity C-Reactive Protein and Left Ventricular Diastolic Function Assessed by Echocardiography in Patients with Cardiovascular Risk Factors
- Seasonal Variation in Estimated Glomerular Filtration Rate Based on Serum Creatinine Levels in Hypertensive Patients
- Elevated serum levels of interleukin-18 in patients with overt diabetic nephropathy : effects of miglitol
- Management of anemia in chronic kidney disease patients : baseline findings from Chronic Kidney Disease Japan Cohort Study
- Chronic Kidney Disease Japan Cohort study : baseline characteristics and factors associated with causative diseases and renal function
- Japan Renal Biopsy Registry : the first nationwide, web-based, and prospective registry system of renal biopsies in Japan
- Influence of adrenomedullin 2/intermedin gene polymorphism on blood pressure, renal function and silent cerebrovascular lesions in Japanese : the Ohasama study
- Long-term effects of candesartan and amlodipine on cardiovascular morbidity and mortality in Japanese high-risk hypertensive patients : the Candesartan Antihypertensive Survival Evaluation in Japan Extension Study (CASE-J Ex)
- Correlation of Arterial Stiffness to Left Ventricular Function in Patients with Reduced Ejection Fraction
- SNPs on chromosome 5p15.3 associated with myocardial infarction in Japanese population
- Association between arterial stiffness and pulmonary function in hypertensive patients