Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2018 01 03() pii S1109-9666(17)30504-3
Arterial stiffness is linked to the progression of atherosclerosis, while activation of vitamin D receptor exerts favorable cardiovascular effects in patients with renal insufficiency. In this study, we investigated the effects of oral treatment with paricalcitol, a potent vitamin D receptor activator on arterial stiffness and osteopontin, a marker of atherosclerosis, in hypertensive patients with chronic kidney disease (CKD) and secondary hyperparathyroidism.
We followed up 29 treated hypertensive patients (mean age 74.1 years, 19 men, office blood pressure=132/85mmHg) with CKD stages 3-5 [mean glomerular filtration rate (GFR)=19.4 ml/min/1.73m2], who were on therapy with oral paricalcitol for 1 year. The control group consisted of 10 age, sex and GFR matched hypertensives with secondary hyperparathyroidism.
After 1 year of treatment with paricalcitol compared to baseline there was no statistical difference in levels of GFR, office blood pressure and osteopontin (p=NS for all), while carotid-femoral PWV was reduced from 11.8±2.6 m/sec to 11.2±2.4 m/sec (p<0.05). The control group exhibited no significant changes in carotid-femoral PWV (p=NS). CONCLUSIONS
Treatment with oral paricalcitol in hypertensive subjects suffering from CKD stages 3-5 and secondary hyperparathyroidism is accompanied by amelioration of arterial stiffness as reflected by the reduction of carotid-femoral PWV.