[Variations in microalbuminuria in essential hypertension treated with ACE inhibitors, calcium antagonists and their association].
OBJECTIVE
Microalbuminuria is an early and sensible marker of renal impairment; furthermore, many authors consider it an independent predictive index for cardiovascular morbidity and mortality. In our study we observed this parameter in hypertensive patients treated respectively with ACE-inhibitors, calcium channel blockers and their combination.


METHODS
Open comparative trial, 6 months follow-up.


METHODS
Outpatients, with no changes from usual lifestyle; office measurements.


METHODS
Forty patients (22 men and 18 women) aged 52-78 years, with essential hypertension and microalbuminuria; diabetics and subjects with renal impairment were excluded.


METHODS
Chronic antihypertensive drug therapy, respectively with nitrendipine 20 mg/die (Group A, n = 10), lisinopril 20 mg/die (Group B, n = 20), and lisinopril 20 mg/die+nitrendipine 20 mg/die (Group C, n = 10); all drugs were administered orally.


METHODS
Detection of urinary albumin excretion with immunochemical method (Micral Test); urine samples were taken immediately after arousal for three consecutive days; office blood pressure monitoring (sitting and standing) during the same day, with at least 2 separate readings.


RESULTS
Out of 34 patients examined at follow-up, (8 from Group A, 17 from Group B and 9 from Group C) urinary albumin excretion rates were as follows: Group A: reduction (but not disappearance) in 3 patients (37%), no change in 4 patients (50%), increase in 1 patient (13%); Group B: disappearance in 11 patients (65%), reduction in 3 patients (17.5%), no changes in 3 patients (17.5%); Group C: reduction (but not disappearance) in 5 patients (55.5%), no changes in 4 patients (44.5%).


CONCLUSIONS
In hypertensive patients not diabetics and not renally impaired with microalbuminuria, ACE-inhibitors appear to be a move suitable drug therapy than calcium channel blockers or the combination ACE-inhibitor+calcium channel blocker.
Regione Siciliana-USL 13 Ospedale, San Giacomo D'Altopasso, Licata, Agrigento.
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D000368:Aged; D000419:Albuminuria / Q000209:etiology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D048909:Diabetes Complications; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017706:Lisinopril / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009568:Nitrendipine / Q000008:administration & dosage*; D012307:Risk Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D009568:Nitrendipine; D017706:Lisinopril
Variazione della microalbuminuria in ipertesi essenziali trattati con ACE-inibitori, calcioantagonisti e loro associazione.