Different patterns of one-year evolution of microalbuminuria in hypertensive patients treated with different inhibitors of the renin-angiotensin system

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Cotter, J (Author) Other; Oliveira, P (Author) Other; Cunha, P (Author) Other; Polonia, J (Author) FMUP

Journal

Title: Revista Portuguesa de Cardiologia

Vol. 27 No. 78

Pages: 1395-1404

ISSN: 0870-2551

Publisher: Sociedade Portuguesa De Cardiologia

Indexing

ISI Web of Knowledge

Scopus - 4 Citations

Other information

Authenticus ID: P-007-PFC

Abstract (EN): Background: In hypertensive patients (HP) with microalbuminuria (MA) it is not known whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have different renoprotective effects. Methods: In a prospective open study we studied 71 adult HP (52 with type 2 diabetes) with MA (urinary albumin excretion rate [UAE] 30-299 mg/g creatinine) and estimated glomerular filtration rate (eGFR, MDRD and Cockcroft-Gault methods) ¿29 ml/min. We evaluated 1-year evolution of UAE, eGFR and blood pressure (BP) in patients undergoing either ARB-based (n=31) or ACEI-based treatment (n=40). Results: At admission the groups taking ARBs and ACEIs did not differ in age (55±14 vs. 60±13 yrs), BP (149/87±15/14 vs. 155/86±21/19 mmHg), gender (55 vs. 55% female), percentage with diabetes (81 vs. 68%) or median UAE (59.2 vs. 68.6 mg/g creatinine). At one year BP remained unchanged, eGFR changed by -0.8±12.0 and - 1.8±10.8 ml/min, and median UAE changed by -13.4 and -8.5 mg/g creatinine, in ARB-and ACEI-based treatments respectively. Regression towards normoalbuminuria (UAE<30 mg/g creatinine) occurred in 11 patients (35.5%) taking ARBs vs. 9 (22.5%) patients taking ACEIs (NS between groups). Progression towards macroalbuminuria (UAE>300 mg/g creatinine) occurred in 1 patient (3%) taking ARBs vs. 8 (20%) patients taking ACEIs (p<0.05). Conclusions: In HP with microalbuminuria, ARBs were superior to ACEIs in reducing 1-year progression to macroalbuminuria despite similar changes in BP, UAE and eGFR and rate of regression to normoalbuminuria.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10