The effects of isradipine and spirapril as monotherapy and combined therapy on blood pressure, renal hemodynamics, natriuresis, and urinary kallikrein in hypertensive nephropathy
| Autor: | Fagundes Vg, E.R. Maccariello, Emilio Antonio Francischetti |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Hypertension Renal Renal function Natriuresis Angiotensin-Converting Enzyme Inhibitors Blood Pressure Plasma renin activity Renal Circulation Excretion Double-Blind Method Enalapril Internal medicine Internal Medicine medicine Albuminuria Humans Spirapril Single-Blind Method Antihypertensive Agents Aged Kidney Isradipine Cross-Over Studies business.industry Effective renal plasma flow Middle Aged Calcium Channel Blockers Renal Plasma Flow Effective Endocrinology medicine.anatomical_structure Drug Therapy Combination Female Kallikreins Kidney Diseases business medicine.drug Glomerular Filtration Rate |
| Zdroj: | American journal of hypertension. 10(5 Pt 1) |
| ISSN: | 0895-7061 |
| Popis: | In this cross-over, double-blind study, 12 essential hypertensive patients (stage I, II, and III) with glomerular filtration rate (GFR) between 50 to 80 mL/min/1.73 m2, were submitted to 4 weeks of placebo followed by 12 weeks with isradipine SRO (IS) 5 mg, spirapril (SP) 6 mg, and isradipine plus spirapril (IS + SP). The study evaluated the effects of these drugs on GFR ((99m)Tc DTPA), effective renal plasma flow (ERPF) ((131)I-orthoiodohippurate), urinary sodium excretion (UNaV), urinary kallikrein excretion (UKal), urinary albumin excretion (UAE), and plasma renin activity (PRA). The three protocols significantly reduced mean blood pressure (128 v 107 mm Hg; 126 v 112 mm Hg; 129 v 104 mm Hg with IS, SP and IS + SP, respectively). ERPF and GFR did not change. UNaV increased significantly after IS (0.17 v 0.22 mEq/min) and IS + SP (0.18 v 0.24 mEq/min). UKal increased significantly after IS (58.6%) and IS + SP (53.6%). UAE decreased significantly only after SP. PRA increased significantly after IS (1.31 v 2.84 ng/mL/h), SP (1.10 v 2.15 ng/mL/h), and after IS + SP (1.23 v 3.21 ng/mL/min). In conclusion, IS, SP and IS + SP were effective in reducing blood pressure while keeping renal function stable. Only SP significantly decreased UAE. Enhanced UKal may have played a role in natriuresis observed after IS and IS + SP. |
| Databáze: | OpenAIRE |
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