MICROALBUMINURIA IN PATIENTS WITH ESSENTIAL-HYPERTENSION - EFFECTS OF SEVERAL ANTIHYPERTENSIVE DRUGS

PURPOSE: Microalbuminuria can be present in 10% to 40% of patients with essential hypertension and is associated with an increased incidence of cardiovascular events. The effect of commonly used antihypertensive agents on urinary albumin excretion (UAE) has not been well established. The aim of this study was to evaluate the effects of a converting enzyme inhibitor, a calcium channel blocker, a beta blocker, and a diuretic on UAE and on creatinine clearance in patients with mild to moderate hypertension. PATIENTS AND METHODS: We prospectively measured UAE prior to and 4 and 8 weeks after treatment with enalapril, nitrendipine, atenolol or a diuretic in 48 patients with essential hypertension and microalbuminuria. RESULTS: All these agents were equally effective in reducing arterial pressure. However, enalapril but not the other agents significantly decreased UAE. CONCLUSION: Eight weeks of therapy with enalapril may reduce UAE in patients with mild to moderate essential hypertension, whereas other agents, such as nitrendipine, atenolol or diuretics, had no measurable effect on UAE. The clinical and prognostic significance of these observations remains to be established.