Key result
Nitrendipine significantly reduced supine blood pressure from 173/102 to 146/81 mm Hg and upright blood pressure from 170/105 to 145/86 mm Hg (p<0.05-0.001).
Why the study?
Does nitrendipine reduce blood pressure and modify pressor factors in hypertensive patients with chronic nonoliguric renal failure?
Does nitrendipine reduce blood pressure and modify pressor factors in hypertensive patients with chronic nonoliguric renal failure?
p-value: p=<0.05-0.001
Nitrendipine effectively reduces blood pressure and cardiovascular dependence on AngII and norepinephrine in patients with hypertension and chronic nonoliguric renal failure.
Nitrendipine may lower BP in hypertensive nonoliguric renal failure; leaves open confirmation of pressor effects and outcomes in trials.
UNLABELLED: To investigate the pathogenetic constellation and its modification by calcium channel blockade in hypertension associated with chronic nonoliguric renal failure, blood pressure (BP), various pressor factors or correlates, cardiovascular responsiveness, and plasma atrial natriuretic peptide (ANP) were assessed in 15 hypertensive patients (serum creatinine 160-715 mumol/l) before and after 6 weeks of intervention with the agent nitrendipine. On placebo, these patients had a lower plasma angiotensin II (AngII) clearance and higher values of supine plasma AngII, aldosterone, norepinephrine (NE), and heart rate than healthy humans. Acute responses of BP to AngII and of heart rate to isoproterenol were blunted in the patients (p less than 0.05-0.001). Plasma ANP was elevated, correlated positively with systolic BP, and rose in response to NE pressor infusion (p less than 0.05-0.001). Exchangeable sodium and blood volume did not differ significantly from normal values. Nitrendipine reduced the cardiovascular responses to AngII, NE, and isoproterenol and lowered supine BP from 173/102 +/- 5/2 to 146/81 +/- 3/3 mm Hg and upright BP from 170/105 +/- 5/2 to 145/86 +/- 4/3 mm Hg (p less than 0.05-0.001); except for slightly increased plasma AngII, the levels of other endocrine variables, exchangeable sodium, blood volume, and creatinine clearance were not significantly modified. CONCLUSIONS: Hypertension accompanying chronic nonoliguric renal impairment seems to be strongly AngII and probably also NE dependent. Circulating ANP levels are high in this setting. Calcium channel blockade with nitrendipine effectively reduces cardiovascular AngII and NE dependence and BP.
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Weidmann et al. (2008) studied Hypertension associated with chronic nonoliguric renal failure (n=15). Nitrendipine vs. Placebo was evaluated on Supine and upright blood pressure (p=<0.05-0.001). Nitrendipine significantly reduced supine blood pressure from 173/102 to 146/81 mm Hg and upright blood pressure from 170/105 to 145/86 mm Hg (p<0.05-0.001).
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