Similar Blood Pressure Drugs Could Have Different Impacts On Dialysis Patients' Heart Health

Main Category: Blood / Hematology
Also Included In: Cardiovascular / Cardiology;  Hypertension;  Urology / Nephrology
Article Date: 11 Dec 2011 - 0:00 PST

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Two seemingly similar blood pressure - lowering drugs have different effects on the heart health of dialysis patients, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results indicate that certain dialysis patients may benefit more from one drug while some should opt for the other.

About 20% of kidney disease patients die within one year after they start dialysis and more than half die after five years - mostly from heart disease. Two classes of drugs, called angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs), act in a similar way to prevent and treat heart disease in the general population. Studies of the drugs in dialysis patients are scarce.

ACE inhibitors and ARBs primarily lower blood pressure, but they also decrease inflammation and can produce other beneficial effects for patients. T. Alp Ikizler, MD (Vanderbilt University Medical Center) and his colleagues looked to see if there is a difference between ACE inhibitor and ARB treatments on dialysis patients' heart health.

The researchers randomized 15 dialysis patients to receive an ACE inhibitor, an ARB, or a placebo for one week. Then patients received no treatment for three weeks, after which they were again randomized to receive an ACE inhibitor, an ARB, or a placebo for one week. This wash-out/treatment cycle was then conducted once more. Tests were conducted after each treatment cycle.

The investigators found that ARBs were more effective at fighting inflammation while ACE inhibitors were better at preventing blood vessel damage. Both of these properties could help prevent heart disease. The results suggest that ACE inhibitors and ARBs have different effects on dialysis patients' heart health that go beyond their similar blood pressure - lowering capabilities.

"The implication is that the choice of each of the drugs in dialysis patients could depend on the profile of each individual considered for treatment, which would be a more personalized approach to therapy," said Dr. Ikizler. This implies that different dialysis patients might respond to each drug differently and that some would get the most benefit from ACE inhibitors while others would benefit more from ARBs. The findings emphasize the need for a long-term randomized clinical trial to compare the effects of ARBs and ACE inhibitors on different aspects of heart health in dialysis patients.

Study co-authors include Jorge Gamboa MD, Mias Pretorius MD, Deanna Todd-Tzanetos MD, James M. Luther MD, Chang Yu, PhD, and Nancy J. Brown MD (Vanderbilt University Medical Center).

Disclosures: Dr. Ikizler is a consultant to Abbott Renal, Abbott Nutrition, Renal Advantage, Inc., AMGEN, Novartis, Bristol Myers Squibb, and Baxter Renal. Dr. Brown is a consultant for Novartis, Merck, and Boehringer-Ingelheim.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our blood / hematology section for the latest news on this subject. "Comparative Effects of Angiotensin-Converting Enzyme Inhibition and Angiotensin-Receptor Blockade on Inflammation during Hemodialysis" online at http://jasn.asnjournals.org/ December 8, 2011, doi: 10.1681/ASN.2011030287.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

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Similar Blood Pressure Drugs Could Have Different Impacts On Dialysis Patients' Heart Health

Main Category: Heart Disease
Also Included In: Urology / Nephrology
Article Date: 09 Dec 2011 - 2:00 PST

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Two seemingly similar blood pressure lowering drugs have different effects on the heart health of dialysis patients, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results indicate that certain dialysis patients may benefit more from one drug while some should opt for the other.

About 20% of kidney disease patients die within one year after they start dialysis and more than half die after five years mostly from heart disease. Two classes of drugs, called angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs), act in a similar way to prevent and treat heart disease in the general population. Studies of the drugs in dialysis patients are scarce.

ACE inhibitors and ARBs primarily lower blood pressure, but they also decrease inflammation and can produce other beneficial effects for patients. T. Alp Ikizler, MD (Vanderbilt University Medical Center) and his colleagues looked to see if there is a difference between ACE inhibitor and ARB treatments on dialysis patients' heart health.

The researchers randomized 15 dialysis patients to receive an ACE inhibitor, an ARB, or a placebo for one week. Then patients received no treatment for three weeks, after which they were again randomized to receive an ACE inhibitor, an ARB, or a placebo for one week. This wash-out/treatment cycle was then conducted once more. Tests were conducted after each treatment cycle.

The investigators found that ARBs were more effective at fighting inflammation while ACE inhibitors were better at preventing blood vessel damage. Both of these properties could help prevent heart disease. The results suggest that ACE inhibitors and ARBs have different effects on dialysis patients' heart health that go beyond their similar blood pressure lowering capabilities.

"The implication is that the choice of each of the drugs in dialysis patients could depend on the profile of each individual considered for treatment, which would be a more personalized approach to therapy," said Dr. Ikizler. This implies that different dialysis patients might respond to each drug differently and that some would get the most benefit from ACE inhibitors while others would benefit more from ARBs. The findings emphasize the need for a long-term randomized clinical trial to compare the effects of ARBs and ACE inhibitors on different aspects of heart health in dialysis patients.

Article adapted by Medical News Today from original press release. Source: American Society of Nephrology
Visit our heart disease section for the latest news on this subject. American Society of Nephrology Please use one of the following formats to cite this article in your essay, paper or report:

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Evaluation Method Supports Soy Protein As A High-Quality Protein Similar To Meat, Eggs And Dairy

Main Category: Nutrition / Diet
Article Date: 08 Dec 2011 - 1:00 PST

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The importance of protein in the human body is undeniable. However, the idea of what makes a protein a "quality protein" has not been as easy to determine. A new study from the Journal of Agriculture and Food Chemistry takes a closer look at the criteria for determining the quality of a protein.

Traditional methods for determining protein quality have shown animal proteins such as milk and eggs to be high in quality. However, those who are interested in a plant-based diet, or diversifying their proteins, have a more difficult time determining which of their choices are high in quality. Testing methods have shown most plant proteins, such as pea protein, are lower in quality than animal-based proteins.

"Accurate methods for determining protein quality are key to helping people plan a healthful diet," said Glenna Hughes, MS, research scientist at Solae. "Due to the increasing interest in including plant-based proteins in the diet, accurate information on protein quality is needed in scientific literature to help educate consumers and healthcare professionals on this topic."

The Food and Agriculture Organization (FAO) and the World Health Organization (WHO) recommend using the protein digestibility-corrected amino acid score (PDCAAS) as a simple and scientific procedure for assessing protein quality. The PDCAAS methodology focuses on three different parameters: the amount of each essential amino acid the protein contains, how easily the protein can be digested, and by taking both of those parameters into account, whether the protein meets the FAO/WHO's amino acid requirements set for children aged two to five years, as they have higher needs to support growth and development than adults.

According to this study, soy protein has a PDCAAS of 1.00, meaning it is a high-quality protein that meets the needs of both children and adults. Eggs, dairy and meat proteins also have a PDCAAS score of 1.0.

However, soy protein is the only widely available high-quality plant-based protein that achieves this score.

"It's important for people to understand that a plant-based diet is healthy, but that not all proteins are created equal," said Connie Diekman, RD, LD, FADA. "If you are planning a vegetarian diet or want to incorporate plant-based proteins in your diet, understanding protein quality using the PDCAAS scale can allow you to select proteins that score higher, such as soy, to ensure that you are getting the essential amino acids you need."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our nutrition / diet section for the latest news on this subject. For more information on the study, the following is a link to the abstract: http://www.ncbi.nlm.nih.gov/pubmed/22017752.
Solae, LLC Please use one of the following formats to cite this article in your essay, paper or report:

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Solae, LLC. "Evaluation Method Supports Soy Protein As A High-Quality Protein Similar To Meat, Eggs And Dairy." Medical News Today. MediLexicon, Intl., 8 Dec. 2011. Web.
8 Dec. 2011. APA

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All opinions are moderated before being included (to stop spam)

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View the original article here