Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/51182
Title: Dissociation between blood pressure reduction and fall in proteinuria in primary renal disease: A randomized double-blind trial
Authors: Ruilope, Luis M.
Fernández, R.
Rodríguez-Pérez, J. C. 
García de Vinuesa, S.
Garrido, J.
Romero, R.
Jarillo, D.
Raij, L.
Alvarez-Cantalapiedra, I.
Lázaro de Mercado, Ma R.
Gómez Campderá, F.
Jarillo Ibáñez, D.
García Martín, F.
Mora-Maciá, J.
Nieto, J.
Vozmediano, C.
Hortal, L.
Plaza, C.
Aljama, P.
Gómez-Carrasco, J. M.
Soriano, S.
Pérez-García, A.
Garcés, L.
Segura, J.
Bonet, J.
Vigil-Medina, A.
Gallar, P.
Oliet, A.
Bernis, C.
Sánz-Guajardo, D.
UNESCO Clasification: 32 Ciencias médicas
3205 Medicina interna
Keywords: Blood pressure
Primary renal disease
Proteinuria
Trandolapril
Verapamil
Issue Date: 2002
Journal: Journal of Hypertension 
Abstract: Objective: Guidelines recommend lower threshold and goal blood pressure (BP) for patients with proteinuria. BP reduction could be accompanied by a different fall in proteinuria depending of the antihypertensive drug. The objective was to compare proteinuria reduction when BP is lowered to the same level with different drugs. Design: Prospective, randomized, double-blind, controlled trial. Setting: 12 Spanish centres. Patients: A total of 119 patients with primary renal disease, blood pressure > 130/85 mmHg, proteinuria > 1 g/day, and creatinine clearance > or = 50 ml/min. Intervention: After a 4-week run-in placebo period, patients were randomized to: atenolol 50 mg/day; trandolapril 2 mg/day; verapamil 240 mg/day or verapamil 180 + trandolapril 2 mg/day combination; forced double-dose titration was carried out at the 4th week. Treatment duration was 6 months. Outcome measures: Changes in BP, 24 h proteinuria, serum albumin and calcium. Results: BP was significantly reduced with the four treatments [SBP/DBP (mmHg]: atenolol 12.2/9.9; trandolapril 12.9/9.3; verapamil 8.2/7.9 and verapamil + trandolapril 13.6/11.3) without differences between them. A significant fall in proteinuria was seen in the trandolapril, 40.2% [95% confidence interval (CI) 24.3-56.2%], and verapamil + trandolapril groups, 48.5% (95% CI, 31.7-64.3%) accompanied with increases in serum albumin (trandolapril: from 3.86 +/- 0.64 to 4.03 +/- 0.67 g/dl; verapamil + trandolapril: from 4.15 +/- 0.58 to 4.40 +/- 0.51 g/dl). Conclusions: In patients with proteinuric primary renal disease, adequate dose titration of antihypertensive drugs may provide a substantial BP reduction. Only angiotensin-converting enzyme inhibitor (trandolapril) treatment, alone or better combined with verapamil, reduces proteinuria and increases serum albumin.
URI: http://hdl.handle.net/10553/51182
ISSN: 0263-6352
DOI: 10.1097/00004872-200204000-00032
Source: Journal of Hypertension[ISSN 0263-6352],v. 20(4), p. 729-737 (Abril 2002)
Appears in Collections:Artículos
Show full item record

SCOPUSTM   
Citations

46
checked on Mar 24, 2024

WEB OF SCIENCETM
Citations

42
checked on Feb 25, 2024

Page view(s)

47
checked on Jan 6, 2024

Google ScholarTM

Check

Altmetric


Share



Export metadata



Items in accedaCRIS are protected by copyright, with all rights reserved, unless otherwise indicated.