Effect of various antihypertensive drugs on microalbuminuria and progression of renal disease in essential hypertension (EH)
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:64A 1997
The long term effects of different antihypertensive regimens on urinary albumin excretion (UAE) and progression of renal disease in essential hypertension (EH) patients are unclear. A retrospective analysis of 141 such patients followed for approximately 7 years was performed. Therapy included ACE inhibitor (52 patients), calcium channel blocker (50) and beta-blocker (39) with or without a thiazide. Goal BP was <140/90 mm Hg. BP was controlled equally well in all groups. UAE decreased by 53%, 3%, and 8% in the ACE, CCB, and beta-blocker groups, respectively. However, decrease in creatinine clearance was the same in the 3 groups (8.6, 10.4, and 8.2 ml/min, respectively). The authors conclude that a reduction in UAE may not predict renoprotection in EH.
Comment: These data suggest that control of BP rather than type of antihypertensive agent is most important in EH. This situation contrasts with that in glomerular diseases, in which controlled studies and meta-analyses have indicated that ACE inhibitors have renoprotective effects that appear to be independent of BP control. (David J. Leehey, M.D., Loyola University at Chicago)
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ASN 30th Annual Meeting, San Antonio
H: Pathophysiology : Kidney in hypertension
CRF by problem area : Progression