| Crucial role of kidney function in resistance to antihypertensive therapy in patients with diabetes mellitus. | |
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MedLine Citation:
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PMID: 20616752 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Effective blood pressure (BP) control is difficult to achieve in diabetic patients. This study investigated factors that exacerbate resistance to antihypertensive medication in patients with diabetes. METHODS: Hypertensive patients with type 2 diabetes (n = 108, 67 ± 9 years) were subjected to a step-wise upward titration of medication (step 1, routine dose of angiotensin receptor blocker; step 2, routine doses of angiotensin receptor blocker and calcium channel blocker; step 3, step 1 + double dose of calcium channel blocker; step 4, double doses of angiotensin receptor blocker and calcium channel blocker; step 5, step 4 + routine dose of diuretic; step 6, step 5 + routine dose of β-blocker; step 7, step 6 + routine dose of α-blocker; step 8, step 6 + double dose of α-blocker) implemented with a target home BP of below 130/80 mmHg. The step number at which target BP was achieved was considered the amount of antihypertensive medications needed for BP control. RESULTS: All patients reached the target BP at step 4.0 ± 1.5. Multivariate regression analysis identified estimated glomerular filtration rate, but not measures of glycemic control, as an independent predictor of the number of drugs needed for BP control (P < 0.0001). CONCLUSION: The number of antihypertensive medications needed for BP control in patients with diabetes mellitus is largely dependent on estimated glomerular filtration rate. Impaired kidney function could produce resistance to antihypertensive therapy in diabetic patients. |
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Authors:
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Masayoshi Kojima; Yasuaki Dohi; Masuo Ohashi; Koichi Sato; Genjiro Kimura |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of hypertension Volume: 28 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-15 Completed Date: 2011-02-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 2323-8 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Komono Kosei Hospital, Komono, Mie, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angiotensin Receptor Antagonists / pharmacology Antihypertensive Agents / pharmacology* Blood Pressure Diabetes Mellitus, Type 2 / pathology* Female Glomerular Filtration Rate Humans Hypertension / drug therapy*, pathology Kidney / physiology* Linear Models Male Middle Aged Prospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin Receptor Antagonists; 0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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