Angiotensin II receptor blocker and long-acting calcium channel blocker combination therapy decreases urinary albumin excretion while maintaining glomerular filtration rate
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概要
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著者最終原稿版Microalbuminuria is a recognized risk factor and predictor for cardiovascular events in patients with hypertension. We analyzed changes in hypotensive effect, urinary albumin excretion (UAE) and estimated glomerular filtration rate (eGFR) in subjects with hypertension and microalbuminuria as a subanalysis of the results of the Nifedipine and Candesartan Combination (NICE-Combi) Study. A total of 86 subjects with essential hypertension with microalbuminuria (UAE <300 mg g(-1) creatinine) were randomly assigned in a double-blind manner to a combination therapy group (standard-dose candesartan at 8 mg per day plus controlled-release (CR) nifedipine 20 mg per day) (n=42) or an up-titrated monotherapy group (candesartan 12 mg per day) (n=44) for 8 weeks of continuous treatment after initially receiving standard-dose candesartan (8 mg per day) monotherapy for 8 weeks (initial treatment). After 8weeks, blood pressure (BP) was significantly reduced in both groups compared with at the end of initial treatment. UAE also showed a significant decrease in the combination therapy group, while there was no significant change of eGFR in either group. A significant positive correlation was seen between BP reduction and UAE after 8 weeks of double-blind treatment in both groups, whereas no significant association was found between ΔUAE and ΔeGFR in either group. These findings show that combination therapy with standard-dose candesartan and nifedipine CR is more effective than up-titrated candesartan monotherapy for reducing BP and improving UAE while maintaining eGFR, and strongly suggest that the combination of an angiotensin II receptor blocker and long-acting calcium channel blocker is beneficial in patients with hypertension and microalbuminuria.
- 2011-10-01
著者
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Takahashi F
Division Of Cardiology Nephrology Pulmonology And Neurology Department Of Internal Medicine Asahikaw
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Hasebe Naoyuki
旭川医科大学 循環呼吸神経病態内科学
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Kikuchi Kenjiro
旭川医科大学 内科学循環呼吸神経病態内科学
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Nakagawa Naoki
Department Of Cardiology Asahikawa Medical College
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Nakagawa Naoki
旭川医科大学 循環呼吸神経病態内科学
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Hasebe N
Cardiovascular Respiratory And Neurology Division Department Of Internal Medicine Asahikawa Medical
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長谷部 直幸
旭川医科大学 循環･呼吸･神経病態内科学分野
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Fujino Takayuki
Division Of Cardiology Nephrology Pulmonology And Neurology Department Of Internal Medicine Asahikaw
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Kikuchi K
Cardiovascular Division Department Of Internal Medicine Asahikawa Medical College
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Hasebe Nayoyuki
旭川医科大学 内科学第一
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Kikuchi Kenjiro
Department Of Cardiology Hokkaido Cardiovascular Hospital
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Hasebe Naoyuki
First Department Of Internal Medicine Asahikawa Medical College And Hospital
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Kikuchi Kenjiro
The First Department Of Medicine (section Of Neurology) Asahikawa Medical College
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Kikuchi Kenjiro
Asahikawa Medical College
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Chinda Junko
Department Of Internal Medicine Hokkaido Prefectural Haboro Hospital
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Hasebe Naoyuki
The First Department Of Internal Medicine Asahikawa Medical College
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Kikuchi Kenjiro
First Department Of Internal Medicine. Asahikawa Medical College
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Kikuchi Kenjiro
The First Department Of Medicine
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Matsuki Motoki
Department Of Cardiovascular Medicine Asahikawa Medical College
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Hasebe Naoyuki
Department Of Cardiology Asahikawa Medical College
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Nakagawa Naoki
Firsto Departmentof Medicine Asahikawa Meedical College
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Matsuki Motoki
First Department Of Internal Medicine Asahikawa Medical College
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Kikuchi Kenjiro
Division Of Cardiology Department Of Internal Medicine Asahikawa Medical University
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Hasebe Naoyuki
Division Of Cardiology Department Of Internal Medicine Asahikawa Medical University
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Chinda Junko
Division Of Nephrology Department Of Medicine Jichi Medical University
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Nakagawa Naoki
Division Of Cardiology Nephrology Pulmonology And Neurology Department Of Internal Medicine Asahikawa Medical University
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Matsuki Motoki
Division Of Cardiology Nephrology Pulmonology And Neurology Department Of Internal Medicine Asahikawa Medical University
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KABARA Maki
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University
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Kabara Maki
Division Of Cardiology Nephrology Pulmonology And Neurology Department Of Internal Medicine Asahikawa Medical University
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Chinda Junko
Division Of Cardiology Nephrology Pulmonology And Neurology Department Of Internal Medicine Asahikawa Medical University
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CHINDA Junko
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University
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中川 直樹
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University
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