Comparison of losartan and amlodipine in renally impaired hypertensive patients

Fernández-Andrade, C; Russo, Domenico; Iversen, Bjame; Zucchelli, P; Aranda, Pedro J.; Guerra, L; Casado, Santos; Fernández-Andrade, D.R. Carlos

doi:10.1038/sj.ki.4490576

Cited by 28 publications

(11 citation statements)

References 15 publications

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“…Clinical practice guidelines from the National Kidney Foundation and the Joint National Committee on Prevention Detection Evaluation and Treatment of High BP call for ACEI as the first line agent for treatment of hypertension in patients with chronic kidney disease (28 -30). In addition, ACEIs or ARBs have renoprotective effects (antiproteinuric) in the progression of diabetic and nondiabetic renal disease independent of antihypertensive effects (26,(31)(32)(33)(34)(35).…”

Section: Testing Therapeutics In Adpkd: the Rationale For The Halt-pkmentioning

confidence: 99%

Approaches to Testing New Treatments in Autosomal Dominant Polycystic Kidney Disease

Chapman

2008

Clinical Journal of the American Society of Nephrology

108

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Section: Testing Therapeutics In Adpkd: the Rationale For The Halt-pkmentioning

confidence: 99%

Approaches to Testing New Treatments in Autosomal Dominant Polycystic Kidney Disease

Chapman

2008

Clinical Journal of the American Society of Nephrology

108

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“…These drugs have been shown to reduce microalbuminuria in patients with essential hypertension and renal impairment and may be an option for patients who are intolerant to side effects of ACE inhibitors [29]. Similar benefits have been demonstrated for nondihydropyridine calcium channel blockers, such as diltiazem and verapamil, in small studies, and these drugs may be considered as supplemental therapy to ACE inhibitors in patients with hypertension and CRF [30].…”

Section: Chronic Renal Insufficiency and Systolic Hypertensionmentioning

confidence: 84%

The need to lower systolic blood pressure

Shrivastava¹,

Kochar

2000

Current Science Inc

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Systolic hypertension is the most common form of hypertension, especially in individuals aged 60 years or older. Systolic hypertension is a reflection of decreasing compliance of large arteries and is a strong independent risk factor for all cardiovascular diseases. Despite proven benefits of therapy for systolic hypertension, only 25% of patients with this condition are adequately treated to attain target blood pressures. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of high blood pressure (JNC VI) recommends the use of diuretics and long-acting dihydropyridine calcium channel blockers as first-line therapy for isolated systolic hypertension. Therapy is also guided by comorbid conditions where certain drugs may have additional benefits. The goal of therapy should be a graded reduction in blood pressure to less than 140/90 mm Hg with lower blood pressure targets in patients with coexistent diabetes or renal failure.

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“…Furthermore, in renallyimpaired hypertensive patients, losartan was more effective than amlodipine in reducing blood pressure and albuminuria [74]. In another study, candesartan cilexetil exerted beneficial effects on renal hemodynamics in patients with impaired renal function [75].…”

Section: Renal Diseasementioning

confidence: 99%

Spectrum of use for the angiotensin-receptor blocking drugs

Fabiani

Johnston

1999

Current Science Inc

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The renin-angiotensin system (RAS) plays an important role in regulating blood pressure, and maintaining fluid and electrolyte balance. Angiotensin II is the principal mediator of the RAS and has been implicated in the development of hypertension as well as other forms of cardiovascular and renal disease. Angiotensin II-receptor antagonists are a new class of drugs that inhibit the RAS by selectively blocking the AT(1) receptor. These compounds therefore provide more specific and thorough blockade of the RAS by inhibiting the deleterious actions of angiotensin II at the receptor level, irrespective of how this peptide is formed. The increased specificity of action of angiotensin II-receptor antagonists may also circumvent unwanted side-effects normally associated with angiotensin-converting enzyme (ACE) inhibitors (eg, cough and angioedema) as these agents do not interfere with the metabolism of other peptides (eg, bradykinin, substance P, etc.). There is still some concern with angiotensin II-receptor antagonists and the long-term effects of hyper-stimulation of the unopposed AT(2) receptor that is caused by elevated levels of angiotensin II. However, it appears that stimulation of the AT(2) receptor may actually contribute to the beneficial effects of angiotensin II-receptor antagonists by counteracting the effects mediated by the AT(1) receptor. Angiotensin II-receptor antagonists display great therapeutic promise in the field of cardiovascular medicine and are currently being exploited as new antihypertensive agents. These drugs have demonstrated safety, efficacy, and tolerability; however, morbidity and mortality data are still lacking. Nonetheless, it is likely that angiotensin II-receptor antagonists will become part of the medical arsenal against cardiovascular and renal disease, thus consideration should be given to their future use as first-line antihypertensive agents.

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Comparison of losartan and amlodipine in renally impaired hypertensive patients

Cited by 28 publications

References 15 publications

Approaches to Testing New Treatments in Autosomal Dominant Polycystic Kidney Disease

Approaches to Testing New Treatments in Autosomal Dominant Polycystic Kidney Disease

The need to lower systolic blood pressure

Spectrum of use for the angiotensin-receptor blocking drugs

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