Microalbuminuria in patients with essential hypertension: effects of several antihypertensive drugs.
OBJECTIVE
Microalbuminuria can be present in 10% to 40% of patients with essential hypertension and is associated with an increased incidence of cardiovascular events. The effect of commonly used antihypertensive agents on urinary albumin excretion (UAE) has not been well established. The aim of this study was to evaluate the effects of a converting enzyme inhibitor, a calcium channel blocker, a beta blocker, and a diuretic on UAE and on creatinine clearance in patients with mild to moderate hypertension.


METHODS
We prospectively measured UAE prior to and 4 and 8 weeks after treatment with enalapril, nitrendipine, atenolol, or a diuretic in 48 patients with essential hypertension and microalbuminuria.


RESULTS
All these agents were equally effective in reducing arterial pressure. However, enalapril but not the other agents significantly decreased UAE.


CONCLUSIONS
Eight weeks of therapy with enalapril may reduce UAE in patients with mild to moderate essential hypertension, whereas other agents, such as nitrendipine, atenolol, or diuretics, had no measurable effect on UAE. The clinical and prognostic significance of these observations remains to be established.
Bianchi
S
S
U.O. di Nefrologia e Dialisi, Spedali Riuniti, Livorno, Italy.
Bigazzi
R
R
Baldari
G
G
Campese
V M
VM
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000517:prevention & control*; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D003404:Creatinine / Q000652:urine; D004232:Diuretics / Q000627:therapeutic use; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects; D009568:Nitrendipine / Q000627:therapeutic use; D011446:Prospective Studies
D000959:Antihypertensive Agents; D004232:Diuretics; D001262:Atenolol; D004656:Enalapril; D009568:Nitrendipine; D003404:Creatinine