Effect of efonidipine and ACE inhibitors on proteinuria in human hypertension with renal impairment

Koichi Hayashi, Hiroo Kumagai, Takao Saruta

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background: Although several lines of recent studies fail to demonstrate the beneficial action of calcium antagonists, a novel dihydropyridine efonidipine, which possesses dilatory action of both afferent and efferent arterioles and, therefore, shares the renal microvascular action with angiotensin converting enzyme (ACE) inhibitors, is reported to exhibit renal protection in experimental animals. Methods: The present study evaluated the effect of efonidipine and ACE inhibitors on blood pressure (BP) and proteinuria. Sixty-eight hypertensive patients with renal impairment (serum creatinine, > 1.5 mg/dL) or chronic renal parenchymal disease were randomly assigned to efonidipine or ACE inhibitor treatment. Of the 68 patients, 23 were treated with efonidipine and 20 with ACE inhibitors; these patients were analyzed for the 48-week study. Results: Both efonidipine and ACE inhibitors produced a similar degree of reductions in BP (efonidipine, from 161 ± 2/93 ± 2 to 142 ± 5/82 ± 2 mm Hg; ACE inhibitor, from 163 ± 3/95 ± 2 to 141 ± 5/83 ± 2 mm Hg), and maintained creatinine clearance for 48 weeks. Proteinuria tended to decrease in both groups, and a significant reduction was observed in proteinuric patients (> 1 g/day) (efonidipine, from 2.7 ± 0.3 to 2.1 ± 0.3 g/day; ACE inhibitor, from 3.0 ± 0.4 to 2.0 ± 0.5 g/day). Of interest, efonidipine decreased proteinuria in proteinuric patients who failed to manifest decreases in systemic BP. Finally, the incidence of adverse effects, including hyperkalemia and cough, was less in the efonidipine-treated group. Conclusions: Both efonidipine and ACE inhibitors preserved renal function in hypertensive patients with renal impairment. The antiproteinuric effect was apparent in patients with greater proteinuria. The beneficial action of efonidipine, along with fewer side effects, may favor the use of this agent in the treatment of hypertension with renal impairment.

Original languageEnglish
Pages (from-to)116-122
Number of pages7
JournalAmerican Journal of Hypertension
Volume16
Issue number2
DOIs
Publication statusPublished - 2003 Feb 1

Fingerprint

Renal Hypertension
Proteinuria
Angiotensin-Converting Enzyme Inhibitors
Kidney
Blood Pressure
Creatinine
efonidipine
Hyperkalemia
Arterioles
Chronic Renal Insufficiency
Cough
Calcium

Keywords

  • ACE inhibitors
  • Efonidipine
  • Hypertension
  • Proteinuria
  • Renal disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of efonidipine and ACE inhibitors on proteinuria in human hypertension with renal impairment. / Hayashi, Koichi; Kumagai, Hiroo; Saruta, Takao.

In: American Journal of Hypertension, Vol. 16, No. 2, 01.02.2003, p. 116-122.

Research output: Contribution to journalArticle

Hayashi, Koichi ; Kumagai, Hiroo ; Saruta, Takao. / Effect of efonidipine and ACE inhibitors on proteinuria in human hypertension with renal impairment. In: American Journal of Hypertension. 2003 ; Vol. 16, No. 2. pp. 116-122.
@article{be49968b5abc4a70949acd0a91fc612b,
title = "Effect of efonidipine and ACE inhibitors on proteinuria in human hypertension with renal impairment",
abstract = "Background: Although several lines of recent studies fail to demonstrate the beneficial action of calcium antagonists, a novel dihydropyridine efonidipine, which possesses dilatory action of both afferent and efferent arterioles and, therefore, shares the renal microvascular action with angiotensin converting enzyme (ACE) inhibitors, is reported to exhibit renal protection in experimental animals. Methods: The present study evaluated the effect of efonidipine and ACE inhibitors on blood pressure (BP) and proteinuria. Sixty-eight hypertensive patients with renal impairment (serum creatinine, > 1.5 mg/dL) or chronic renal parenchymal disease were randomly assigned to efonidipine or ACE inhibitor treatment. Of the 68 patients, 23 were treated with efonidipine and 20 with ACE inhibitors; these patients were analyzed for the 48-week study. Results: Both efonidipine and ACE inhibitors produced a similar degree of reductions in BP (efonidipine, from 161 ± 2/93 ± 2 to 142 ± 5/82 ± 2 mm Hg; ACE inhibitor, from 163 ± 3/95 ± 2 to 141 ± 5/83 ± 2 mm Hg), and maintained creatinine clearance for 48 weeks. Proteinuria tended to decrease in both groups, and a significant reduction was observed in proteinuric patients (> 1 g/day) (efonidipine, from 2.7 ± 0.3 to 2.1 ± 0.3 g/day; ACE inhibitor, from 3.0 ± 0.4 to 2.0 ± 0.5 g/day). Of interest, efonidipine decreased proteinuria in proteinuric patients who failed to manifest decreases in systemic BP. Finally, the incidence of adverse effects, including hyperkalemia and cough, was less in the efonidipine-treated group. Conclusions: Both efonidipine and ACE inhibitors preserved renal function in hypertensive patients with renal impairment. The antiproteinuric effect was apparent in patients with greater proteinuria. The beneficial action of efonidipine, along with fewer side effects, may favor the use of this agent in the treatment of hypertension with renal impairment.",
keywords = "ACE inhibitors, Efonidipine, Hypertension, Proteinuria, Renal disease",
author = "Koichi Hayashi and Hiroo Kumagai and Takao Saruta",
year = "2003",
month = "2",
day = "1",
doi = "10.1016/S0895-7061(02)03147-3",
language = "English",
volume = "16",
pages = "116--122",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Effect of efonidipine and ACE inhibitors on proteinuria in human hypertension with renal impairment

AU - Hayashi, Koichi

AU - Kumagai, Hiroo

AU - Saruta, Takao

PY - 2003/2/1

Y1 - 2003/2/1

N2 - Background: Although several lines of recent studies fail to demonstrate the beneficial action of calcium antagonists, a novel dihydropyridine efonidipine, which possesses dilatory action of both afferent and efferent arterioles and, therefore, shares the renal microvascular action with angiotensin converting enzyme (ACE) inhibitors, is reported to exhibit renal protection in experimental animals. Methods: The present study evaluated the effect of efonidipine and ACE inhibitors on blood pressure (BP) and proteinuria. Sixty-eight hypertensive patients with renal impairment (serum creatinine, > 1.5 mg/dL) or chronic renal parenchymal disease were randomly assigned to efonidipine or ACE inhibitor treatment. Of the 68 patients, 23 were treated with efonidipine and 20 with ACE inhibitors; these patients were analyzed for the 48-week study. Results: Both efonidipine and ACE inhibitors produced a similar degree of reductions in BP (efonidipine, from 161 ± 2/93 ± 2 to 142 ± 5/82 ± 2 mm Hg; ACE inhibitor, from 163 ± 3/95 ± 2 to 141 ± 5/83 ± 2 mm Hg), and maintained creatinine clearance for 48 weeks. Proteinuria tended to decrease in both groups, and a significant reduction was observed in proteinuric patients (> 1 g/day) (efonidipine, from 2.7 ± 0.3 to 2.1 ± 0.3 g/day; ACE inhibitor, from 3.0 ± 0.4 to 2.0 ± 0.5 g/day). Of interest, efonidipine decreased proteinuria in proteinuric patients who failed to manifest decreases in systemic BP. Finally, the incidence of adverse effects, including hyperkalemia and cough, was less in the efonidipine-treated group. Conclusions: Both efonidipine and ACE inhibitors preserved renal function in hypertensive patients with renal impairment. The antiproteinuric effect was apparent in patients with greater proteinuria. The beneficial action of efonidipine, along with fewer side effects, may favor the use of this agent in the treatment of hypertension with renal impairment.

AB - Background: Although several lines of recent studies fail to demonstrate the beneficial action of calcium antagonists, a novel dihydropyridine efonidipine, which possesses dilatory action of both afferent and efferent arterioles and, therefore, shares the renal microvascular action with angiotensin converting enzyme (ACE) inhibitors, is reported to exhibit renal protection in experimental animals. Methods: The present study evaluated the effect of efonidipine and ACE inhibitors on blood pressure (BP) and proteinuria. Sixty-eight hypertensive patients with renal impairment (serum creatinine, > 1.5 mg/dL) or chronic renal parenchymal disease were randomly assigned to efonidipine or ACE inhibitor treatment. Of the 68 patients, 23 were treated with efonidipine and 20 with ACE inhibitors; these patients were analyzed for the 48-week study. Results: Both efonidipine and ACE inhibitors produced a similar degree of reductions in BP (efonidipine, from 161 ± 2/93 ± 2 to 142 ± 5/82 ± 2 mm Hg; ACE inhibitor, from 163 ± 3/95 ± 2 to 141 ± 5/83 ± 2 mm Hg), and maintained creatinine clearance for 48 weeks. Proteinuria tended to decrease in both groups, and a significant reduction was observed in proteinuric patients (> 1 g/day) (efonidipine, from 2.7 ± 0.3 to 2.1 ± 0.3 g/day; ACE inhibitor, from 3.0 ± 0.4 to 2.0 ± 0.5 g/day). Of interest, efonidipine decreased proteinuria in proteinuric patients who failed to manifest decreases in systemic BP. Finally, the incidence of adverse effects, including hyperkalemia and cough, was less in the efonidipine-treated group. Conclusions: Both efonidipine and ACE inhibitors preserved renal function in hypertensive patients with renal impairment. The antiproteinuric effect was apparent in patients with greater proteinuria. The beneficial action of efonidipine, along with fewer side effects, may favor the use of this agent in the treatment of hypertension with renal impairment.

KW - ACE inhibitors

KW - Efonidipine

KW - Hypertension

KW - Proteinuria

KW - Renal disease

UR - http://www.scopus.com/inward/record.url?scp=0037307604&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037307604&partnerID=8YFLogxK

U2 - 10.1016/S0895-7061(02)03147-3

DO - 10.1016/S0895-7061(02)03147-3

M3 - Article

C2 - 12559677

AN - SCOPUS:0037307604

VL - 16

SP - 116

EP - 122

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 2

ER -