Key result
Benidipine, but not amlodipine, in combination with olmesartan significantly reduced urinary albumin excretion to 11.7 mg/g creatinine (P<0.05) in elderly hypertensive patients with CKD.
Why the study?
Does benidipine reduce urine albumin compared to amlodipine when added to olmesartan in elderly hypertensive patients with chronic kidney disease?
RCT (n=17)
randomly assigned
Does benidipine reduce urine albumin compared to amlodipine when added to olmesartan in elderly hypertensive patients with chronic kidney disease?
p-value: p=<0.05
In elderly hypertensive patients with CKD, combining olmesartan with benidipine, but not amlodipine, significantly reduced urinary albumin excretion despite similar blood pressure reductions.
May support benidipine over amlodipine with olmesartan to reduce albuminuria in elderly hypertensive CKD; extends differential CCB renal effects beyond BP lowering.
Anti-hypertensive medication with an angiotensin II receptor blocker (ARB) is effective in slowing the progression of chronic kidney disease. The present study was designed to investigate whether calcium channel blockers (CCBs) in combination with an ARB differentially affect kidney function. Elderly hypertensive patients with chronic kidney disease (n = 17, 72 +/- 6 years old) were instructed to self-measure blood pressure. They were randomly assigned to receive either benidipine (4-8 mg/day) or amlodipine (5-10 mg/day) combined with olmesartan (10 mg/day). After 3 months, CCBs were switched in each patient and the same protocol was applied for another 3 months. At baseline, significant correlation was obtained between urine albumin (22.8 +/- 16.7 (median +/- median absolute deviation) mg/g creatinine) and self-measured blood pressure (170 +/- 23/87 +/- 10 (mean +/- SD) mmHg, r = 0.65, p < 0.01). Both regimens reduced blood pressure to a similar extent (139 +/- 22/75 +/- 11 mmHg and 133 +/- 17/72 +/- 10 mmHg, respectively; both p < 0.001), while urine albumin decreased only after combination therapy including benidipine (11.7 +/- 6.1 mg/g creatinine, p < 0.05). Benidipine, but not amlodipine, in combination with olmesartan, reduced urinary albumin excretion in elderly hypertensive patients with chronic kidney disease. The results suggest the importance of selecting medications used in combination with ARB in hypertensive patients with chronic kidney disease.
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Miyagawa et al. (2010) conducted an RCT in Hypertension with chronic kidney disease (n=17). Benidipine combined with olmesartan vs. Amlodipine 5-10 mg/day + olmesartan 10 mg/day was evaluated on urinary albumin excretion (p=<0.05). Benidipine, but not amlodipine, in combination with olmesartan significantly reduced urinary albumin excretion to 11.7 mg/g creatinine (P<0.05) in elderly hypertensive patients with CKD.
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