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Vol. 90, No. 2, 2002
Issue release date: February 2002
Section title: Original Paper
Nephron 2002;90:169–173
(DOI:10.1159/000049038)

Changes in Renal Resistive Index and Urinary Albumin Excretion in Hypertensive Patients under Long-Term Treatment with Lisinopril or Nifedipine GITS

Leoncini G. · Martinoli C. · Viazzi F. · Ravera M. · Parodi D. · Ratto E. · Vettoretti S. · Tomolillo C. · Derchi L.E. · Deferrari G. · Pontremoli R.
Di MI, Section of Nephrology and DiCMI, Section of Radiology, University of Genoa, Italy

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 1/30/2002
Issue release date: February 2002

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF

Abstract

Introduction: Increased renal vascular resistance and microalbuminuria are associated with hypertensive target organ damage and may be predictors of hypertensive nephrosclerosis. Aim: We investigated changes in renal resistive index (RI) and urinary albumin excretion (UAE) in a group of patients with primary hypertension before and during long-term antihypertensive treatment. Methods: Thirty-two patients were randomized to receive antihypertensive treatment with either a calcium channel blocker (nifedipine GITS, up to 90 mg/day, n = 16) or an ACE inhibitor (lisinopril, up to 20 mg/day, n = 16), alone or in association with a diuretic (chlortalidone, 25 mg/day). Blood pressure, renal resistive index (by US Doppler) and UAE (mean of three nonconsecutive timed urinary collections, µg/min) were evaluated at baseline and over the course of 24 months of treatment. Results: Both regimens effectively lowered blood pressure (mean blood pressure from 123 ± 1.8 at baseline to 103 ± 1.5 mm Hg at 24 months in the lisinopril group and from 122 ± 1.9 at baseline to 104 ± 0.8 at 24 months in the nifedipine group, p < 0.001 for both groups). Overall, blood pressure decrease was associated with a reduction in UAE and no change in RI throughout the study. However, despite similar blood pressure reduction, the two regimens showed different specific effects. Lisinopril was associated with a significant decrease in both UAE (33.8 ± 16.2 at baseline and 9.1 ± 2.1 at 24 months, p < 0.01) and renal RI (0.61 ± 0.02 at baseline and 0.56 ± 0.04 at 24 months, p < 0.05) while nifedipine GITS did not significantly influence UAE (35.7 ± 12.2 at baseline and 31.2 ± 12.1 at 24 months, n.s.) or RI (0.61 ± 0.01 at baseline and 0.59 ± 0.02 at 24 months, n.s.). Conclusion: Effective blood pressure control over a long period of time reduces the severity of organ damage, namely UAE while maintaining renovascular resistance in patients with essential hypertension. Different classes of antihypertensive agents might convey additional specific renal protection beyond blood pressure control. These data could be useful in devising individualized therapeutic strategies in hypertensive patients at increased renal risk.

© 2002 S. Karger AG, Basel


  

Author Contacts

Roberto Pontremoli, MD, PhD
Department of Internal Medicine, Section of Nephrology
University of Genoa, Viale Benedetto XV, 6
I–16132 Genoa (Italy)
Fax +39 02 700 415427, E-Mail rpontrem@tin.it

  

Article Information

Accepted: January 10, 2001
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 2, Number of References : 18

  

Publication Details

Nephron
Founded 1964 by G. Richet and G.E. Schreiner

Vol. 90, No. 2, Year 2002 (Cover Date: February 2002)

Journal Editor: G.M. Berlyne, Brooklyn, N.Y./Beersheva; S. Ito, Sendai
ISSN: 0028–2766 (print), 1423–0186 (Online)

For additional information: http://www.karger.com/journals/nef


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 1/30/2002
Issue release date: February 2002

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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