Evidence map›Paper›PMID 24026038›Full record

Trial reportHypertension research : official journal of the Japanese Society of Hypertension2013

Effects of dual blockade of the renin-angiotensin system on renal and cardiovascular outcomes in type 2 diabetes with overt nephropathy and hypertension in the ORIENT: a post-hoc analysis (ORIENT-Hypertension).

Enyu Imai, Masakazu Haneda, Tetsu Yamasaki, Fumiaki Kobayashi, Atsushi Harada, Sadayoshi Ito, Juliana C N Chan, Hirofumi Makino

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Hypertension research : official journal of the Japanese Society of Hypertension, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. New therapeutic hope for rare podocytopathies.Pediatric nephrology (Berlin, Germany) · 2026
    Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. The necessity and effectiveness of mineralocorticoid receptor antagonist in the treatment of diabetic nephropathy.Hypertension research : official journal of the Japanese Society of Hypertension · 2015
    Review
  10. The Prevalence and Management of Diabetic Nephropathy in Asia.Kidney diseases (Basel, Switzerland) · 2015
    Review
  11. Review
  12. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 3 countries.

Enyu ImaiNakayamadera Imai Clinic, Takarazuka, Japan.
Masakazu Haneda
Tetsu Yamasaki
Fumiaki Kobayashi
Atsushi Harada
Sadayoshi Ito
Juliana C N Chan
Hirofumi Makino
Daiichi Sankyo (India) · INAsahikawa Medical University · JPDaiichi-Sankyo (Japan) · JPOkayama University · JPPrince of Wales Hospital · CNTakara (Japan) · JPTohoku University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Combination therapy with angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors (ACEIs) requires further evaluation in patients with diabetic nephropathy and hypertension. In a post hoc analysis of the Olmesartan Reducing Incidence of Endstage renal disease in diabetic Nephropathy Trial with hypertension, we examined the effects of olmesartan on renal and cardiovascular outcomes in the presence or absence of an ACEI. Among 563 patients randomized to receive either olmesartan (n = 280) or placebo (n = 283), 73.5% (n = 414) received a concomitant ACEI. Compared with placebo, olmesartan significantly reduced proteinuria in both the ACEI-treated and non-ACEI-treated groups. The respective changes in the urinary protein creatinine ratio in the olmesartan-treated and placebo-treated groups were -32.6% and +21.1% without an ACEI (P = 0.001) and -17.0% and +2.2% with an ACEI (P = 0.028). In the olmesartan group, 115 patients developed primary renal outcomes (41.1%) compared with 129 (45.6%) in the placebo group (hazard ratio (HR): 0.97, P = 0.787). The respective HRs in the ACEI-treated and non-ACEI-treated groups were 1.02 (P = 0.891) and 0.84 (P = 0.450). 40 olmesartan-treated patients (14.3%) and 53 placebo-treated patients (18.7%) developed secondary cardiovascular outcomes (HR: 0.65, P = 0.042). The respective HRs in the ACEI-treated and non-ACEI-treated groups were 0.69 (P = 0.129) and 0.51 (P = 0.129). Olmesartan was well tolerated. Dual blockade treatment caused more hyperkalemia than monotherapy. In patients with diabetic nephropathy and hypertension, olmesartan significantly reduced proteinuria, independent of ACEI treatment and cardiovascular outcome but failed to show additional renal benefit compared with ACEI treatment alone. The cardiovascular benefit of dual treatment requires further evaluation.

Indexed as

AgedAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersAntihypertensive AgentsBlood PressureDiabetes Mellitus, Type 2Diabetic NephropathiesDrug Therapy, CombinationFemaleGlomerular Filtration RateHemodynamicsHumansHypertensionImidazolesKaplan-Meier EstimateKidney Function TestsAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersAntihypertensive AgentsImidazolesolmesartanTetrazoles

Identifiers

PMID24026038
PMCPMC3853587
OpenAlexW1973695494

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.