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Journal
2008 | 3 | 3 | 287-293
Article title

Antiproteinuric effects of antihypertensive agents in non-diabetic hypertensive population

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EN
Abstracts
EN
Arterial hypertension and proteinuria are important factors associated with the progression of both diabetic and nondiabetic chronic kidney disease. The objective of the present study was to determine the influence of different antihypertensive drug groups on urinary albumin excretion (UAE) as related to blood pressure in non-diabetic population. Subjects (n=39) with chronic renal disease accompanied by mild to moderate hypertension and varying degrees of proteinuria were divided into 3 groups based on UAE values and placed on nonpharmacological and/or treatment with an antihypertensive drug regimen (consisting of one or more antihypertensive drugs [beta blocker, ACE inhibitor or calcium-channel blocker]) to achieve a target blood pressure ≤ 130/85 mmHg. Periodic UAE measurements were performed. A reduction was observed over time in most patients, however, it reached statistical significance only in the microalbuminuric group (P<0.01). Patients were further stratified into 5 groups depending on assigned therapy: 0, nonpharmacological treatment; 1-drug group 1; 12-drug groups 1 and 2; 13-drug groups 1 and 3; 123-all 3 drug groups (1-ACE inhibitors, 2-beta blockers, 3-calcium channel blockers). A statistically significant change in mean UAE values at the start and end of the study period in patients assigned to drug groups 12, 13, and 123 was achieved (P < 0.05). Also, there was a statistically significant difference in the average reduction of proteinuria under varying antihypertensive drug regimens (P < 0.05). In conclusion, in patients with hypertension, changes in UAE depend on initial UAE values and administered antihypertensive treatment. ACE inhibitors combined with calcium channel blockers resulted in a higher UAE reduction than other drug groups.
Publisher

Journal
Year
Volume
3
Issue
3
Pages
287-293
Physical description
Dates
published
1 - 9 - 2008
online
10 - 7 - 2008
Contributors
author
  • Department of Pharmacology and Toxicology, Medical Faculty, University of Nis, Nis, Serbia
  • Department of Internal Medicine, University Clinical Center, Nis, Serbia
author
  • Department of Pharmacology and Toxicology, Medical Faculty, University of Nis, Nis, Serbia, karin12675@yahoo.com
author
  • Department of Physiology, Medical Faculty, University of Nis, Nis, Serbia
  • Medical Faculty, University of Nis, Nis, Serbia
References
  • [1] Wenzel RR., Renal protection in hypertensive patients: selection of antihypertensive therapy, Drugs, 2005, 65 Suppl 2, 29–39 http://dx.doi.org/10.2165/00003495-200565002-00005[Crossref]
  • [2] Wolf S. and Risler T., Are all antihypertensive drugs renoprotective?, Herz, 2004, 29(3), 248–254 (in German) http://dx.doi.org/10.1007/s00059-003-2508-6[Crossref]
  • [3] Viberti G.C., Hill R.D., Jarrett R.J., Argyropoulos A., Mahmud U., Keen H., Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus, Lancet, 1982, 1, 1430–1432 http://dx.doi.org/10.1016/S0140-6736(82)92450-3[Crossref]
  • [4] Peterson J.C., Adler S., Burkart J.M., Greene T., Herbert L.A., Hunsicker L.G., et al., Blood pressure control, proteinuria, and the progression of renal disease, The Modification of Diet in Renal Disease Study, Ann. Intern. Med.,1995, 123, 754–762
  • [5] Tanaka H., Hayashi M., Date C., Imai K., Asada M., Shoji H., et al., Epidemiologic studies of stroke in Shibata, a Japanese provincial city: Preliminary report on risk factors for cerebral infarction, Stroke, 1985, 16, 773–780 [Crossref]
  • [6] Yudkin J.S., Forrest R.D., Jackson C., Microalbuminuria as predictor of vascular disease in non-diabetic subjects: Islington Diabetes Survey, Lancet, 1988, 2, 530–533 http://dx.doi.org/10.1016/S0140-6736(88)92657-8[Crossref]
  • [7] Haffner S.M., Stern M.P., Gruber M.K., Hazuda H.P., Mitchell B.D., Patterson J.K., Microalbuminuria: Potential marker for increased cardiovascular risk factors in nondiabetic subjects?, Arteriosclerosis, 1990, 10, 727–731 [Crossref]
  • [8] Samuelsson O., Hypertension in middle-aged men: Management, morbidity and prognostic factors during long-term hypertensivecare, Acta Med. Scand. Suppl., 1985, 702, l–79
  • [9] Mogensen C.E., Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes, N. Engl. J. Med., 1984, 310, 356–360
  • [10] Gerstein H.C., Mann J.F., Yi Q., Zinman B., Dinneen S.F., Hoogwerf B., et al., Albuminuria and risk ofcardiovascular events, death, and heart failure in diabetic and nondiabetic individuals, JAMA, 2001, 286, 421–426 http://dx.doi.org/10.1001/jama.286.4.421[Crossref]
  • [11] Hillege H.L., Fidler V., Diercks G.F., van Gilst W.H., de Zeeuw D., van Veldhuisen D.J., et al., Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population, Circulation, 2002, 106, 1777–1782 http://dx.doi.org/10.1161/01.CIR.0000031732.78052.81[Crossref]
  • [12] Redon J., Renal protection by antihypertensive drugs: insights from microalbuminuria studies, J. Hypertens., 1998, 16, 2091–2100 http://dx.doi.org/10.1097/00004872-199816121-00035[Crossref]
  • [13] Maki D.D., Ma J.Z., Louis T.A., Kasiske B.L., Long-term effects of antihypetensive agents on proteinuria and renal function, Arch. Intern. Med., 1995, 155, 1073–1080 http://dx.doi.org/10.1001/archinte.155.10.1073[Crossref]
  • [14] Gansevoort R.T., Sluiter W.J., Hemmelder M.H., de Zeeuw D., de Jong P.E., Antiproteinuric effect of blood-pressure-lowering agents: a meta-analysis of comparative trials, Nephrol. Dial. Transplant., 1995, 10, 1963–1974
  • [15] Giatras I., Lau J., Levey A.S., Effect of angiotensinconverting enzyme inhibitors on the progression of non-diabetic renal disease: a meta-analysis of randomized trials. Angiotensin-Converting Enzyme Inhibition and Progressive Renal Disease Study Group, Ann. Intern. Med., 1997, 127, 337–345
  • [16] Preston R.A., Renoprotective effects of antihypertensive drugs, Am. J. Hypertens., 1999, 12, 19S–32S http://dx.doi.org/10.1016/S0895-7061(98)00210-6[Crossref]
  • [17] Erley C.M., Haefele U., Heyne N., Braun N., Risler T., Microalbuminuria in essential hypertension, Reduction by different antihypertensive drugs, Hypertension, 1993, 21, 810–815 [Crossref]
  • [18] Himmelmann A., Hansson L., Hansson B.G., Hedstrand H., Skogstrom K., Ohrvik J., et al., ACE inhibition preserves renal function better than beta blockade in the treatment of essential hypertension, Blood Press., 1995, 4, 85–90 http://dx.doi.org/10.3109/08037059509077575[Crossref]
  • [19] Manjunath G., Sarnak M.J., Levey A.S., Prediction equations to estimate glomerular filtration rate: An update, Curr. Opin. Nephrol. Hypertens., 2001, 10, 785–792 http://dx.doi.org/10.1097/00041552-200111000-00009[Crossref]
  • [20] The GISEN Group (Gruppo Italiano di Studi Epidemiologici in Nefrologia), Randomised placebocontrolled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy, Lancet, 1997, 349, 1857–1863 http://dx.doi.org/10.1016/S0140-6736(96)11445-8[Crossref]
  • [21] Lewis E.J., Hunsicker L.G., Bain R.P., Rohde R.D., The effect of angiotensin-convertingenzyme inhibition on diabetic nephropathy, The Collaborative Study Group, N. Engl. J. Med., 1993, 329, 1456–1462 http://dx.doi.org/10.1056/NEJM199311113292004[Crossref]
  • [22] Salvetti A., Mattei P., Sudano I., Renal protection and antihypertensive drugs: current status, Drugs, 1999, 57, 665–693 http://dx.doi.org/10.2165/00003495-199957050-00002[Crossref]
  • [23] Cirillo M. and De Santo N.G., Microalbuminuria in nondiabetic adults, G. Ital. Nefrol., 2002, 19, 273–277
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.-psjd-doi-10_2478_s11536-008-0036-8
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