Document Detail


Role of combination therapy with ACE inhibitors and calcium channel blockers in renal protection.
MedLine Citation:
PMID:  12410856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Over recent years, a target blood pressure of 125/75 mm Hg has been sought in order to reduce the rate of chronic renal disease (CKD) progression and cardiovascular mortality. Some antihypertensive agents, such as angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists and calcium channel blockers also may be capable of reducing CKD progression because they halt some of the pathogenetic mechanisms involved in renal damage. The possibility that combination treatments with ACE inhibitors and calcium-channel blockers may confer additive or even synergistic renoprotective effects other than blood pressure control is not only fascinating, but also particularly important because multidrug antihypertensive regimens are required to obtain adequate blood pressure in the majority of patients with CKD. This combination may provide better blood pressure control, appears to be better tolerated with fewer side effects than either drug alone, and may exert a greater renoprotective effect in patients at risk for renal failure than either an ACE inhibitors or a calcium channel blocker. However, the current available data are too few to confirm this hypothesis. Cardiovascular disease accounts for more than 50% of the deaths of hemodialysis patients. Thus, care must be taken to prevent and treat the cardiovascular risk factors optimally from the early phase of CKD, and for this reason effective antihypertensive therapy is the most important treatment, not only in order to delay CKD progression, but also to reduce the burden of cardiovascular disease. In this perspective combination therapy with ACE inhibitors and calcium channel blockers can give further advantages.
Authors:
Francesco Locatelli; Lucia Del Vecchio; Simeone Andrulli; Sara Colzani
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Kidney international. Supplement     Volume:  -     ISSN:  0098-6577     ISO Abbreviation:  Kidney Int. Suppl.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-04     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7508622     Medline TA:  Kidney Int Suppl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S53-60     Citation Subset:  IM    
Affiliation:
Department of Nephrology and Dialysis, Ospedale A. Manzoni, Lecco, Italy. nefrologia@ospedale.lecco.it
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / adverse effects,  therapeutic use*
Antihypertensive Agents / adverse effects,  therapeutic use*
Blood Pressure / drug effects
Calcium Channel Blockers / adverse effects,  therapeutic use*
Disease Progression
Drug Therapy, Combination
Humans
Hypertension / complications,  drug therapy*,  physiopathology
Proteinuria / etiology,  physiopathology,  prevention & control*
Renal Insufficiency, Chronic / etiology,  physiopathology,  prevention & control*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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