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Calcium antagonism in essential hypertension: effect on renal haemodynamics and microalbuminuria
B Persson1, O K Andersson, M Wysocki
1Department of Medicine, Sahlgren's Hospital, University of Gothenburg, Sweden.
Insights
This study found that isradipine, a calcium antagonist, effectively lowers blood pressure in hypertensive men by reducing peripheral resistance. However, it did not significantly alter urinary albumin excretion rates.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Primary hypertension is a significant risk factor for cardiovascular and renal disease.
- Urinary albumin excretion rate (UAE) is a marker of kidney damage and cardiovascular risk.
- Calcium antagonists are a class of antihypertensive drugs with varying effects on renal parameters.
Purpose of the Study:
- To investigate the effects of the calcium antagonist isradipine on blood pressure, systemic and renal hemodynamics, hemorheological properties, and urinary albumin excretion in men with primary hypertension.
Main Methods:
- A randomized, placebo-controlled, double-blind cross-over study involving 16 middle-aged men with primary hypertension.
- Treatment with isradipine over a 9-week period.
- Assessment of urinary albumin excretion rate, systemic and renal hemodynamics, hemorheological properties, and plasma hormone/renin activity.
Main Results:
- Isradipine significantly reduced blood pressure by decreasing peripheral resistance.
- No significant influence of isradipine treatment on the mean urinary albumin excretion rate was observed.
- Multivariate analysis indicated that changes in urinary albumin excretion were solely related to blood pressure changes.
Conclusions:
- Isradipine is effective in lowering blood pressure in hypertensive men through reduced peripheral resistance.
- Isradipine does not appear to directly impact urinary albumin excretion in this hypertensive cohort.
- Blood pressure reduction is the primary determinant of changes in urinary albumin excretion in the context of isradipine treatment.
Abstract:
Sixteen middle-aged men with primary hypertension were treated with the calcium antagonist isradipine over a 9-week period in a randomized, placebo-controlled, double-blind cross-over manner. At the end of the intervention period the urinary albumin excretion rate, systemic and renal haemodynamics, haemorheological properties of blood and plasma concentrations of atrial natriuretic peptide, noradrenaline and peripheral renin activity were determined. Treatment with isradipine resulted in a substantial reduction in blood pressure due to a reduction in peripheral resistance. The mean albumin excretion rate was not influenced by the isradipine treatment. In a multivariate analysis, changes in the urinary albumin excretion rate were only related to changes in blood pressure.