Effects of enalapril and nitrendipine on the excretion of epidermal growth factor and albumin in hypertensive NIDDM patients.
OBJECTIVE
To compare the effect of the antihypertensive drugs nitrendipine and enalapril on the excretion of epidermal growth factor (EGF) and albumin in hypertensive non-insulin-dependent diabetes mellitus (NIDDM) subjects.


METHODS
After a 4-week washout period, mildly hypertensive (systolic blood pressure [sBP] > or = 140 mmHg and/or diastolic blood pressure [dBP] > or = 90 mmHg) NIDDM patients with albuminuria (15-200 micrograms/min) were randomized into an 8-month-long therapy with either nitrendipine (n = 11) or enalapril (n = 10). Blood pressure, EGF, and microalbumin excretion were measured at baseline and throughout the treatment period.


RESULTS
A significant fall in sBP was noticed in the enalapril group and in dBP in the nitrendipine group. In the enalapril group, EGF excretion progressively increased from 188 to 214 nmol/mmol creatinine after 6 weeks and to 274 after 8 months of therapy (P = 0.03). There was a significant fall in albumin excretion while patients were on enalapril, but in the nitrendipine group, neither albuminuria nor EGF excretion changed significantly. There was no correlation of improved EGF excretion with a decrease in albuminuria or BP.


CONCLUSIONS
The angiotensin-converting enzyme inhibitor enalapril has been effective in decreasing albumin and increasing EGF excretion. Measurement of urinary EGF may provide a new valuable index of renal function.
Josefsberg
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Faculty of Medicine, University of Calgary, Alberta, Canada.
Ross
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SA
Lev-Ran
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Hwang
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D000328:Adult; D000368:Aged; D000419:Albuminuria; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure / Q000187:drug effects; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000652:urine*; D003925:Diabetic Angiopathies / Q000188:drug therapy / Q000652:urine*; D004656:Enalapril / Q000494:pharmacology / Q000627:therapeutic use*; D004815:Epidermal Growth Factor / Q000652:urine*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000652:urine*; D008875:Middle Aged; D009568:Nitrendipine / Q000494:pharmacology / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D015415:Biomarkers; D004815:Epidermal Growth Factor; D004656:Enalapril; D009568:Nitrendipine; D003404:Creatinine