Why the study?
Does lisinopril compared to nitrendipine reduce urinary albumin excretion in patients with mild to moderate essential hypertension and microalbuminuria?
Does lisinopril compared to nitrendipine reduce urinary albumin excretion in patients with mild to moderate essential hypertension and microalbuminuria?
Lisinopril, but not nitrendipine, reduces urinary albumin excretion in essential hypertensive patients with microalbuminuria independently of its antihypertensive effect.
Lisinopril should be prioritized over nitrendipine to reduce microalbuminuria in hypertensive patients; confirms BP-independent renoprotective effects of ACE inhibitors.
The present study was designed to evaluate the effects of an ACE inhibitor, lisinopril, and a calcium antagonist, nitrendipine, on urinary albumin excretion (UAE) and renal function in mild to moderate essential hypertensive patients with microalbuminuria. After the 4-week drug-free period, 17 patients were randomly divided into two groups. The first group (group 1: n=8) received lisinopril 10-20 mg daily for 8 weeks followed by nitrendipine 5-10 mg daily for another 8 weeks. The second group (group 2: n=9) received nitrendipine 5-10 mg daily for 8 weeks followed by lisinopril 10-20 mg daily for another 8 weeks. The mean blood pressure (MBP) significantly decreased in a similar manner in both groups. UAE significantly decreased after 8 weeks of treatment with lisinopril in group 1 and after 8 weeks of subsequent treatment with lisinopril in group 2. On the other hand, UAE was not altered by treatment with nitrendipine. The changes in UAE were significantly correlated with changes in MBP after 8 weeks of treatment with nitrendipine, but not after 8 weeks of treatment with lisinopril. No significant changes in creatinine clearance, urinary excretion of sodium or urinary N-acetyl-beta-D-glucosaminide were observed by any treatment in either group. These results suggest that lisinopril, not nitrendipine, reduces UAE in essential hypertensive patients with microalbuminuria independently of its effective antihypertensive properties.
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Ogawa et al. (2000) studied this question.
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