Lone-Term Effects of a Converting Enzyme Inhibitor and a Calcium Channel Blocker on Urinary Albumin Excretion in Patients With Essential Hypertension

Bigazzi, Roberto; Bianchi, Stefano; Baldari, Duccio; Sgherri, Gianpaolo; Baldari, Giorgio; Campese, Vito M.

doi:10.1093/ajh/6.2.108

Cited by 36 publications

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“…36 Which of these factors predominates remains to be established. Unlike previous studies which found no significant effect of dihydropyridine CCBs on UAE, 18,21,22,37,38 in our study we observed a reduction of UAE in the nitrendipine-treated patients, but such an antiproteinuric effect became statistically significant only after 1 year of treatment and was less pronounced as compared to the ramipril induced UAE reduction. This finding suggests two considerations: (a) first, the reduction in UAE from nitrendipine could be mainly attributed to the decrease in systemic BP rather than to other intrinsic effects of the drug, which is supported by the correlation between the UAE and the SBP changes that we found in the nitrendipine but not in the ramipril-treated patients.…”

Section: Discussioncontrasting

confidence: 99%

Long-term effects of ramipril and nitrendipine on albuminuria in hypertensive patients with type II diabetes and impaired renal function

et al. 1999

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The aim of this study was to compare the effects of ramipril and nitrendipine chronic treatment on urinary albumin excretion (UAE) in hypertensive patients with type II non-insulin-dependent diabetes mellitus (NIDDM) and impaired renal function. A 2-year, prospective, randomised study was conducted on 51 men with a diastolic blood pressure (DBP) у95 and р105 mm Hg, stable NIDDM, serum creatinine between 1.6 and 3.0 mg/dl and persistent UAE Ͼ300 and Ͻ2000 mg/24 h. After a 3-month preliminary observation period, during which patients began a low-protein, low-sodium diet, and a subsequent 4-week run-in period on placebo, patients were randomly treated with ramipril 5 mg or nitrendipine 20 mg for 2 years. Both drugs similarly reduced BP without affecting glucose homeostasis. In the ramipril group

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Section: Discussioncontrasting

confidence: 99%

Long-term effects of ramipril and nitrendipine on albuminuria in hypertensive patients with type II diabetes and impaired renal function

et al. 1999

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“…Previous studies had documented the beneficial effect of ACE inhibitors on urinary albumin excretion. 8,21 Clinical beneficial effects of ACE inhibition in microalbuminuric subjects have been well documented 10,11,22 ; however, it is important to realize that these previous studies with diabetic subjects used higher cutoff values than PREVEND IT. The study described by Ravid et al 10 included normotensive Plus-minus values are meanϮSD.…”

Section: Effect Of Ace Inhibitor Interventionmentioning

confidence: 99%

Effects of Fosinopril and Pravastatin on Cardiovascular Events in Subjects With Microalbuminuria

et al. 2004

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Background-Microalbuminuria is associated with increased risk of cardiovascular events. We assessed whether therapeutic intervention aimed at lowering urinary albumin excretion would reduce cardiovascular events in microalbuminuric subjects (15 to 300 mg/24 hours). Methods and Results-From the Prevention of Renal and Vascular Endstage Disease (PREVEND) cohort (nϭ8592), 1439 subjects fulfilled the inclusion criteria of the PREVEND Intervention Trial (PREVEND IT). Of these subjects, 864 were randomized to fosinopril 20 mg or matching placebo and to pravastatin 40 mg or matching placebo. The mean follow-up was 46 months, and the primary end point was cardiovascular mortality and hospitalization for cardiovascular morbidity. Mean age was 51Ϯ12 years; 65% of subjects were male, and 3.4% had a previous cardiovascular event. Mean cholesterol level was 5.8Ϯ1.0 mmol/L, mean systolic/diastolic blood pressure was 130Ϯ18/76Ϯ10 mm Hg, and median urinary albumin excretion was 22.8 (15.8 to 41.3) mg/24 hours. The primary end point occurred in 45 subjects (5.2%). Fosinopril reduced urinary albumin excretion by 26% (PϽ0.001). Subjects treated with fosinopril showed a 40% lower incidence of the primary end point (hazard ratio 0.60 [95% CI 0.33 to 1.10], Pϭ0.098, log-rank). Pravastatin did not reduce urinary albumin excretion, and subjects treated with pravastatin showed a 13% lower incidence of the primary end point than subjects in the placebo group (0.87 [0.49 to 1.57], Pϭ0.649, log-rank). Conclusions-In microalbuminuric subjects, treatment with fosinopril had a significant effect on urinary albumin excretion. In addition, fosinopril treatment was associated with a trend in reducing cardiovascular events. Treatment with pravastatin did not result in a significant reduction in urinary albumin excretion or cardiovascular events.

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“…105 Further, albeit indirect, evidence for a role of angiotensin II in microalbuminuria development is represented by the stronger anti-albuminuric effect exerted by the ACE inhibitors as compared with other antihypertensive drugs. [42][43][44] Cigarette smoke Similar to type 1 and 2 diabetics, 106,107 non-diabetic smokers, hypertensive or not, tend to excrete more albumin ( Table 5). The first report by Gosling et 114 and may expose to higher risk of morbid events when coexisting with elevated UAE.…”

Section: -99mentioning

confidence: 99%

Microalbuminuria, an integrated marker of cardiovascular risk in essential hypertension

et al. 2002

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This paper reviews the existing epidemiological and clinical evidence about the relationships of non-diabetic microalbuminuria with cardiovascular risk factors such as elevated blood pressure (BP), systolic particularly, cardiac hypertrophy, adverse metabolic status, smoking habits, elevated angiotensin II levels, endothelial dysfunction, acute and perhaps subclinical inflammation. Because of that unique property of reflecting the influence of so many clinically relevant parameters, microalbuminuria may legitimately be defined as an integrated marker of cardiovascular risk, an unique profile among the several prognostic predictors available to

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Lone-Term Effects of a Converting Enzyme Inhibitor and a Calcium Channel Blocker on Urinary Albumin Excretion in Patients With Essential Hypertension

Cited by 36 publications

References 0 publications

Long-term effects of ramipril and nitrendipine on albuminuria in hypertensive patients with type II diabetes and impaired renal function

Long-term effects of ramipril and nitrendipine on albuminuria in hypertensive patients with type II diabetes and impaired renal function

Effects of Fosinopril and Pravastatin on Cardiovascular Events in Subjects With Microalbuminuria

Microalbuminuria, an integrated marker of cardiovascular risk in essential hypertension

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