Clinical significance of renal function in hypertensive patients at high risk: Results from the INSIGHT trial

Peter W. De Leeuw, Luis M. Ruilope, Christopher R. Palmer, Morris J. Brown, Alain Castaigne, Giuseppe Mancia, Talma Rosenthal, Gilbert Wagener

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Background: Increasing evidence suggests renal involvement in hypertension-related cardiovascular and cerebrovascular complications. To assess this role of renal function in more detail, we studied the evolution of renal function and the relationship of renal function with mortality and morbidity in the Intervention as a Goal in Hypertension Treatment (INSIGHT) study. Methods: The INSIGHT study was a double-blind, randomized, multicenter trial in patients with hypertension and at least 1 additional cardiovascular risk factor. Treatment consisted of nifedipine gastrointestinal therapeutic system, 30 mg/d, or hydrochlorothiazide-amiloride (25 mg/d of hydrochlorothiazide and 2.5 mg/d of amiloride hydrochloride). Primary outcome was a composite of cardiovascular death, myocardial infarction, heart failure, and stroke. Renal function was assessed by measuring creatinine clearance, serum creatinine level, and serum uric acid level and by the presence of proteinuria. Results: Creatinine clearance fell more in nifedipine recipients than in hydrochlorothiazide- amiloride recipients. Renal insufficiency developed in 2% of nifedipine recipients and 5% of hydrochlorothiazide-amiloride recipients. Primary outcomes occurred in 15% of patients with increased serum creatinine levels and 6% of patients with normal levels (odds ratio [OR] 2.89; 95% confidence interval [CI], 1.92-4.36; P

Original languageEnglish
Pages (from-to)2459-2464
Number of pages6
JournalArchives of Internal Medicine
Issue number22
Publication statusPublished - Dec 13 2004

ASJC Scopus subject areas

  • Internal Medicine


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