Heart failure and renal outcomes with angiotensin receptor blockers compared with calcium channel blockers in patients with chronic kidney disease: a target trial emulation
Main finding · Heart failure hospitalisationResult — go to the resultHazard ratio 0.871 95% CI 0.751–1.011Authors' 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
- Participants
- 12,978 patients
- Comparison
- ARB-based versus CCB-based antihypertensive treatment strategies
- ARB-based therapyn = 4,524
- CCB-based therapyn = 8,454reference
- Outcome
- Heart failure hospitalisation
Methodological detailssequentially 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
- 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
Main finding
As reported in the abstract
Hazard ratio
0.871
95% CI 0.751–1.011
ARB-based therapyvs CCB-based therapy
HR 0.871 (95% CI 0.751–1.011)
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
Heart failure and renal outcomes with angiotensin receptor blockers compared with calcium channel blockers in patients with chronic kidney disease: a target trial emulation. Heart. Published 23 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →