Inadequacy of cardiovascular risk factor management in chronic kidney transplantation - evidence from the FAVORIT study.
Carpenter M.A, Weir M.R, et al.Clinical Transplantation 2012; 26(4): E438-446.
Aims
To describe the prevalence of cardiovascular disease (CVD) risk factors and the use of CVD risk factor lowering medications in kidney transplant recipients.
Interventions
The CVD prevalence and risk factor data used in this study was taken from the FAVORIT study baseline visit. The FAVORIT trial was a randomized, double-blind controlled trial evaluating the impact of homocysteine-lowering vitamin therapy on cardiovascular disease in stable kidney transplant recipients.
Participants
4107 kidney transplantation recipients with elevated homocysteine and stable graft function.
Outcomes
Hypertension, CVD and medication use including blood pressure lowering tablets, lipid lowering medications, anti-platelet and anti-diabetic medications.
Follow-up
Data were collected from patients who were on average 5 years post-transplant.
CET Conclusions
In the context of a multinational RCT of vitamin therapy for cardiovascular disease in renal transplant recipients (FAVORIT study) this new paper audits the management of cardiovascular risk factors. The management of hypertension was concerning in that 70% of patients taking at least one antihypertensive agent still had a blood pressure >130/80mmH and 44% of patients taking at least one antihypertensive had a blood pressure >140/90mmHg. 60% of patients with borderline or elevated LDL (>130mg/dL) were untreated and 31% of patients with prevalent cardiovascular disease were not using antiplatelet agents.
Data analysis
Per protocol analysis
Quality notes
Score based on Bostom A.G., Carpenter M.A, et al. Homocysteine-lowering and cardiovascular disease outcomes in kidney transplant recipients: primary results from the folic acid for vascular outcome reduction in transplantation trial. Circulation 2011; 123(16): 1763-1770.
Trial registration
Not reported.