MICROALBUMINURIA IN PATIENTS WITH ESSENTIAL-HYPERTENSION - EFFECTS OF AN ANGIOTENSIN CONVERTING-ENZYME-INHIBITOR AND OF A CALCIUM-CHANNEL BLOCKER

被引：45

作者：

BIANCHI, S ^{[1
]}

BIGAZZI, R ^{[1
]}

BALDARI, G ^{[1
]}

CAMPESE, VM ^{[1
]}

机构：

[1] UNIV SO CALIF,DIV NEPHROL,2025 ZONAL AVE,LOS ANGELES,CA 90033

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1991年 / 4卷 / 04期

关键词：

URINARY ALBUMIN EXCRETION; ESSENTIAL HYPERTENSION; ENALAPRIL; NITRENDIPINE;

D O I：

10.1093/ajh/4.4.291

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Several patients with essential hypertension manifest an abnormal (> 30 mg/24 h) urinary albumin excretion (UAE). Since microalbuminuria is considered an independent predictor of cardiovascular morbidity and mortality, studies are currently being undertaken to determine the effect of various anti-hypertensive agents on UAE, on the assumption that a reduction of UAE might result in improved prognosis in patients with essential hypertension. Twenty-four patients with essential hypertension were randomly divided into two groups of 12. The first group received 20 mg/day enalapril for 8 weeks, followed by 20 to 40 mg/day nitrendipine for 8 more weeks. The second group received nitrendipine for 8 weeks, followed by enalapril. Mean arterial pressure decreased similarly during both therapeutic regimens in the two groups of patients. In patients of group 1, UAE decreased significantly (P < .01) from 74 +/- 7.0 to 33 +/- 5.8 mg/24 h after 8 weeks of treatment with enalapril; during the following 8 weeks of treatment with nitrendipine, UAE increased to 58 +/- 5.3 mg/24 h (P < .02). In patients of group 2, UAE did not change during the first 8 weeks of therapy with nitrendipine despite a significant reduction in blood pressure; subsequently, after 8 weeks of therapy with enalapril, UAE decreased from 62 +/- 9.2 to 31 +/- 4.8 mg/24 h (P < .01). This study demonstrates that enalapril but not nitrendipine may reduce UAE in patients with essential hypertension despite similar antihypertensive efficacy. The significance of microalbuminuria and the impact of the normalization of UAE on cardiovascular morbidity and mortality in patients with essential hypertension remains to be determined. Am

引用

页码：291 / 296

页数：6

共 40 条

[1] Kincaid-Smith P., The Kidney: A Clinico-Pathological Study, (1975)
[2] Rostand S.G., Kirk K.A., Rutsky E.A., Et al., Racial differences in the incidence of treatment for end-stage renal disease, N Engl J Med, 306, pp. 1276-1279, (1982)
[3] Lewin A., Blaufox D., Castle H., Et al., Apparent prevalence of curable hypertension in the Hypertension Detection and Follow-up Program, Arch Intern Med, 145, pp. 424-427, (1985)
[4] Bulpitt C.J., Beevers D.G., Butler A., Coles E.C., Et al., The survival of treated hypertensive patients and their causes of death: A report from the DHSS Hypertensive Care Computing Project (DHCCP), J Hypertens, 4, pp. 93-99, (1986)
[5] Kannel W.B., Stampfer M.J., Castelli W.P., Et al., The prognostic significance of proteinuria: The Framingham Study, Am Heart J, 108, pp. 1347-1352, (1984)
[6] Parving H.H., Jensen H.E., Mogensen C.E., Evrin P.E., Increased urinary albumin excretion in benign essential hypertension, Lancet, 1, pp. 231-237, (1974)
[7] Giaconi S., Levanti C., Fommei E., Et al., Microalbuminuria and causal and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension, Am J Hypertens, 2, pp. 259-261, (1989)
[8] Pedersen E.B., Mogensen C.E., Effect of antihypertensive treatment on urinary albumin excretion, glomerular filtration rate and renal plasma flow in patients with essential hypertension, Scand J Clin Lab Invest, 36, pp. 231-237, (1976)
[9] Bianchi S., Bigazzi R., Baldari G., Evidence of different daily urinary albumin excretion in patients with mild to moderate essential hypertension, J Nephrology, 2, (1989)
[10] Parving H.H., Oxenboll B., Svendsen P.A., Et al., Early detection of patients at risk of developing diabetic nepro-pathy: A longitudinal study of urinary albumin excretion, Acta Endocrinol, 100, pp. 550-555, (1982)

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