The effects of cinacalcet on blood pressure, mortality and cardiovascular endpoints in the EVOLVE trial

dc.contributor.authorChang, T. I.
dc.contributor.authorAbdalla, S.
dc.contributor.authorLondon, G. M.
dc.contributor.authorBlock, G. A.
dc.contributor.authorCorrea-Rotter, R.
dc.contributor.authorDrüeke, T. B.
dc.contributor.authorFloege, J.
dc.contributor.authorHerzog, C. A.
dc.contributor.authorMahaffey, K. W.
dc.contributor.authorMoe, Sharon M.
dc.contributor.authorParfrey, P. S.
dc.contributor.authorWheeler, D. C.
dc.contributor.authorDehmel, B.
dc.contributor.authorGoodman, W. G.
dc.contributor.authorChertow, G. M.
dc.contributor.departmentDepartment of Medicine, IU School of Medicineen_US
dc.date.accessioned2016-10-28T16:08:59Z
dc.date.available2016-10-28T16:08:59Z
dc.date.issued2016-03
dc.description.abstractPatients with end-stage renal disease often have derangements in calcium and phosphorus homeostasis and resultant secondary hyperparathyroidism (sHPT), which may contribute to the high prevalence of arterial stiffness and hypertension. We conducted a secondary analysis of the Evaluation of Cinacalcet Hydrochloride Therapy to Lower Cardiovascular Events (EVOLVE) trial, in which patients receiving hemodialysis with sHPT were randomly assigned to receive cinacalcet or placebo. We sought to examine whether the effect of cinacalcet on death and major cardiovascular events was modified by baseline pulse pressure as a marker of arterial stiffness, and whether cinacalcet yielded any effects on blood pressure. As reported previously, an unadjusted intention-to-treat analysis failed to conclude that randomization to cinacalcet reduces the risk of the primary composite end point (all-cause mortality or non-fatal myocardial infarction, heart failure, hospitalization for unstable angina or peripheral vascular event). However, after prespecified adjustment for baseline characteristics, patients randomized to cinacalcet experienced a nominally significant 13% lower adjusted risk (95% confidence limit 4–20%) of the primary composite end point. The effect of cinacalcet was not modified by baseline pulse pressure (Pinteraction=0.44). In adjusted models, at 20 weeks cinacalcet resulted in a 2.2 mm Hg larger average decrease in systolic blood pressure (P=0.002) and a 1.3 mm Hg larger average decrease in diastolic blood pressure (P=0.002) compared with placebo. In summary, in the EVOLVE trial, the effect of cinacalcet on death and major cardiovascular events was independent of baseline pulse pressure.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationChang, T. I., Abdalla, S., London, G. M., Block, G. A., Correa-Rotter, R., Drüeke, T. B., … Chertow, G. M. (2016). The effects of cinacalcet on blood pressure, mortality and cardiovascular endpoints in the EVOLVE trial. Journal of Human Hypertension, 30(3), 204–209. http://doi.org/10.1038/jhh.2015.56en_US
dc.identifier.urihttps://hdl.handle.net/1805/11284
dc.language.isoenen_US
dc.publisherNatureen_US
dc.relation.isversionof10.1038/jhh.2015.56en_US
dc.relation.journalJournal of Human Hypertensionen_US
dc.rightsPublisher Policyen_US
dc.sourceAuthoren_US
dc.subjectrenal diseaseen_US
dc.subjectcinacalceten_US
dc.subjectblood pressureen_US
dc.subjectEVOLVEen_US
dc.titleThe effects of cinacalcet on blood pressure, mortality and cardiovascular endpoints in the EVOLVE trialen_US
dc.typeArticleen_US
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