Key result
Amlodipine and arotinolol decreased posterior wall thickness from 14.2 to 12.9 cm over 2 years in patients with renal insufficiency and LVH, whereas amlodipine and benazepril did not.
Why the study?
Does amlodipine plus arotinolol compared to amlodipine plus benazepril improve renal function and left ventricular hypertrophy in hypertensive patients with chronic renal insufficiency?
RCT (n=65)
Randomized
Does amlodipine plus arotinolol compared to amlodipine plus benazepril improve renal function and left ventricular hypertrophy in hypertensive patients with chronic renal insufficiency?
Combination therapy with a calcium antagonist and an alpha-beta blocker may be more effective than a calcium antagonist and an ACE inhibitor for preventing progression of LVH and renal dysfunction in hypertensive patients with chronic renal insufficiency.
Answers are grounded in this paper and cite their sources.
May support amlodipine-arotinolol over amlodipine-benazepril for LVH regression in hypertensive renal insufficiency; extends comparative data on antihypertensive combinations.
The aim of this study was to compare the effects of an angiotensin-converting enzyme (ACE) inhibitor and alphabeta blocker in combination with a calcium antagonist on the progression of renal function and left ventricular hypertrophy (LVH) in patients with chronic renal insufficiency and hypertension. The 65 subjects in this study were recruited from a cohort of 316 patients. The main criteria for inclusion were echocardiographic diagnosis of LVH (posterior wall thickness >12 mm) and serum creatinine of more than 1.5 mg/dl. Antihypertensive treatments were switched to the combination of amlodipine at a dose of 5 mg and benazepril at a dose of 2.5 mg daily or the combination of amlodipine at a dose of 5 mg and arotinolol at a dose of 20 mg daily at random irrespective of whether or not patients had been previously treated. The follow-up period was 2 years. Systolic and diastolic blood pressure were significantly reduced from 150/90 +/- 15/11 mmHg to 130/75 +/- 11/9 mmHg (ACE) and the levels of serum creatinine were increased significantly from 1.8 +/- 0.3 to 2.0 +/- 0.4 mg/dl (ACE). In the alphabeta-blocker group, these two values were similar and no significant changes were found. PWT was decreased from 14.2 +/- 0.6 to 12.9 +/- 0.3 cm in alphabeta blocker but was not significantly decreased in the ACE inhibitor group. In conclusion, combination therapy with a calcium antagonist and abeta blocker might be effective treatment for hypertensive patients with chronic renal insufficiency and left ventricular hypertrophy.
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Suzuki et al. (2001) conducted an RCT in Chronic renal insufficiency and hypertension with left ventricular hypertrophy (n=65). Amlodipine and arotinolol vs. Amlodipine 5 mg and benazepril 2.5 mg daily was evaluated on Progression of renal function and left ventricular hypertrophy. Amlodipine and arotinolol decreased posterior wall thickness from 14.2 to 12.9 cm over 2 years in patients with renal insufficiency and LVH, whereas amlodipine and benazepril did not.
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