Cardiometabolic & kidneyResearch article
Heart failure and renal outcomes with angiotensin receptor blockers compared with calcium channel blockers in patients with chronic kidney disease: a target trial emulation
- target trial emulation
- sequentially nested new-user trials
- 1-month induction-period approach
- nationwide-scale healthcare claims and health check-up data in Japan
- inverse probability of treatment and censoring weighting
- accounting for competing risks
Authors' conclusion
In this nationwide target trial emulation, ARB-based antihypertensive strategies were associated with lower risks of kidney failure and all-cause mortality, with a directionally lower but statistically uncertain risk of heart failure hospitalisation. These findings suggest that ARB-based antihypertensive strategies may confer clinically relevant cardiorenal benefits compared with CCB-based strategies in patients with CKD, although causal interpretation remains limited by the observational design.
Study context
- Population
- Patients with chronic kidney disease (CKD) in Japan, April 2014 to September 2024patients with CKD · initiating ARB-based therapy 4,524 · initiating CCB-based therapy 8,454
- Participants
- 12,978 patients
- Comparison
- ARB-based versus CCB-based antihypertensive treatment strategies
- ARB-based therapyn = 4,524
- CCB-based therapyn = 8,454reference
Main finding
Heart failure hospitalisation
Hazard ratio
0.871
95% CI 0.751–1.011
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Progression to end-stage renal disease | 0.533 (0.317–0.898) | |
| All-cause mortality | 0.825 (0.706–0.963) | |
| 0.20.5125Hazard ratio (log scale) |
Myocardial infarction or stroke
- No consistent differences were observed for myocardial infarction or stroke
Original publication
Summarised from the published abstract; every number is checked against it