| Direct comparison of the effects of valsartan and amlodipine on renal hemodynamics in human essential hypertension. | |
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MedLine Citation:
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PMID: 14643577 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To elucidate the renoprotective mechanism of AT(1)-receptor blockers, we compared the effects of the AT(1)-receptor blocker valsartan with those of the calcium channel blocker amlodipine on renal hemodynamics and microcirculation. METHODS: A total of 58 patients (50.2 +/- 9.0 years) with mild to moderate essential hypertension were included in a randomized, double-blind study to receive either valsartan (80 to 160 mg) or amlodipine (5 to 10 mg). Renal plasma flow (RPF) and glomerular filtration rate (GFR) were measured before and after 8 weeks of treatment. Glomerular hydrostatic pressure (P(Glo)) and resistances of the afferent (R(A)) and efferent (R(E)) arterioles were calculated according to the Gomez formulas. RESULTS: Blood pressure control was similar in both groups. RPF did not change with either treatment. In contrast, GFR increased with amlodipine (+8 +/- 14 mL/min; P <.01) but was preserved with valsartan. Amlodipine caused a more marked increase in the R(E)/R(A) ratio than valsartan (+0.26 +/- 0.26 v +0.13 +/- 0.24, P <.05), which was paralleled by an increase in P(Glo) in patients treated with amlodipine (+1.9 +/- 4.3 mm Hg; P <.05) but not in those treated with valsartan. CONCLUSIONS: At similar blood pressure control, valsartan maintained GFR and P(Glo), whereas amlodipine led to glomerular hyperfiltration and an increase in P(Glo). The results might explain the favorable renal outcome with AT(1)-receptor blocker therapy. |
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Authors:
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Christian Delles; Arnfried U Klingbeil; Markus P Schneider; Renate Handrock; Gottfried Weidinger; Roland E Schmieder |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of hypertension Volume: 16 ISSN: 0895-7061 ISO Abbreviation: Am. J. Hypertens. Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2003-12-03 Completed Date: 2004-04-13 Revised Date: 2009-02-24 |
Medline Journal Info:
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Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 1030-5 Citation Subset: IM |
Affiliation:
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Department of Medicine IV/4, University of Erlangen-Nürnberg, Nuremberg, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amlodipine
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pharmacology*,
therapeutic use Antihypertensive Agents / pharmacology*, therapeutic use Double-Blind Method Glomerular Filtration Rate / drug effects* Humans Hypertension / drug therapy Microcirculation / drug effects Middle Aged Renal Circulation / drug effects* Tetrazoles / pharmacology*, therapeutic use Valine / analogs & derivatives, pharmacology*, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine; 88150-42-9/Amlodipine |
| Comments/Corrections | |
Comment In:
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Am J Hypertens. 2004 Jul;17(7):638-9; author reply 639-40
[PMID:
15233985
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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