Antihypertensive and renoprotective effects of trandolapril/verapamil combination: a meta-analysis of randomized controlled trials

Zou, Zui; Xu, FY; Wang, L; An, MM; Zhang, H; Shi, XY

doi:10.1038/jhh.2010.60

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…18 However, the renoprotective effect of calcium channel blockers is contentious. [19][20][21][22] Conversely, the up-titration of doses of ARBs is likely to bring about beneficial results because of the protective effects of these drugs on the kidney, as supported by considerable evidence in the literature. Thus, the aim of the present study was to generate a hypothesis that up-titrating the dose of an ARB would be superior to combined treatment with an ARB plus a calcium channel blocker, with respect to renal protection for the same level of BP achieved and the same degree of BP reduction in patients, with albuminuria being treated with a standard dose of an ARB.…”

Section: Introductionmentioning

confidence: 88%

Effects of up-titration of candesartan versus candesartan plus amlodipine on kidney function in type 2 diabetic patients with albuminuria

Okura¹,

Kojima

Machida

et al. 2011

J Hum Hypertens

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In the present study, we tested the hypothesis that uptitrating the dose of an angiotensin receptor blocker (ARB) is superior to combined treatment with an ARB and a calcium channel blocker for the same degree of blood pressure (BP) reduction, with respect to urinary albumin excretion in diabetic patients treated with a standard dose of the ARB. Hypertensive patients with type 2 diabetes mellitus and albuminuria (X30 mg g À1 creatinine) were enroled in the study, and were either started on or switched to candesartan (8 mg per day) monotherapy. After a 12-week run-in period, baseline evaluations were performed and patients with BP X130/80 mm Hg were randomly assigned to receive either candesartan (12 mg per day) or candesartan (8 mg per day) plus amlodipine (2.5 mg per day) for a further 12 weeks. The primary endpoint was a reduction in urinary albumin levels. Although there was no significant difference in the BP reduction between the two groups, the reduction in urinary albumin was greater in the up-titrated than the combination therapy group (À40 ± 14% vs À9 ± 38%, respectively; Po0.0001). Thus, up-titration of candesartan more effectively reduces urinary albumin excretion than combined candesartan plus amlodipine in hypertensive patients with diabetes for the same degree of BP reduction.

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