Add-on benefits of amlodipine and thiazide in nondiabetic chronic kidney disease stage 1/2 patients treated with valsartan

Yuki Kaneshiro, Atsuhiro Ichihara, Mariyo Sakoda, Asako Kurauchi-Mito, Kenichiro Kinouchi, Hiroshi Itoh

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

Hypertension frequently requires combination therapy to attain efficient control to prevent cardiovascular diseases effectively. This study was conducted to determine which add-on treatment is better, namely calcium channel blockers or diuretics, in improving vascular damage. In 70 nondiabetic chronic kidney disease stage 1/2 patients who had been already treated with angiotensin II type 1 receptor blocker valsartan for at least 12 months, amlodipine or hydrochlorothiazide was added to their existing medication. Pulse wave velocity (PWV), intima-media thickness (IMT) of the carotid arteries, urinary albumin excretion (UAE), and 24-hour ambulatory blood pressure (BP) were determined before and 12 months after the start of add-on treatments. Add-on amlodipine and add-on hydrochlorothiazide significantly and similarly decreased 24-hour ambulatory BP by 18 and 19 mm Hg, respectively, PWV by 206 and 184 cm/s, respectively, and UAE, but did not change the IMT. The decreases in BP significantly contributed to the decreases in PWV and UAE and suggested that the decrease in serum cholesterol level brought about by add-on amlodipine also contributed to the decrease in UAE. These results suggest that 12 months of add-on treatment with either amlodipine or hydrochlorothiazide could have beneficial effects in nondiabetic chronic kidney disease stage 1/2 patients already being treated with valsartan.

Original languageEnglish
Pages (from-to)51-58
Number of pages8
JournalKidney and Blood Pressure Research
Volume32
Issue number1
DOIs
Publication statusPublished - 2009 Mar 1

Keywords

  • Chronic kidney disease
  • Intima-media thickness
  • Pulse wave velocity
  • Urinary albumin excretion

ASJC Scopus subject areas

  • Nephrology
  • Cardiology and Cardiovascular Medicine

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