Antihypertensive and anti-albuminuric effects of losartan potassium and felodipine in Chinese elderly hypertensive patients with or without non-insulin-dependent diabetes mellitus.
After a 4-week placebo baseline period, 29 Chinese elderly hypertensive patients were randomized, double-blind, to 12 weeks of treatment with either losartan potassium (n = 19), an angiotensin II antagonist at the AT1 receptor, or felodipine (n = 10), a calcium channel blocking agent. Of these 29 patients 12 had coexisting non-insulin-dependent diabetes mellitus. At week 12, the mean reductions (95% confidence intervals) in mean arterial pressure were similar in both groups: losartan -18 (range -22 to -14) mm Hg; felodipine -19 (range -25 to -11) mm Hg. In the whole group, the 24-hour urinary albumin excretion was reduced by 27% with losartan as compared with no change in the felodipine-treated group (p = 0.03; analysis of variance). In the diabetic group, losartan treatment reduced the urinary albumin excretion by 24% as compared with 11% in the felodipine-treated group. In the non-diabetic patients, the urinary albumin excretion fell by 29% in the losartan-treated group, but increased by 14% in the felodipine-treated group (p < 0.001; repeated-measures analysis of variance). Plasma sodium increased to a similar extent in both groups. The fasting plasma triglyceride level declined by 25% (p < 0.001 within group) with losartan, but was not significantly reduced in the felodipine-treated group. For comparable reductions in blood pressure, a greater reduction in albuminuria was seen with losartan than with felodipine treatment in Chinese hypertensive patients with or without non-insulin-dependent diabetes mellitus. Long-term studies are required to examine whether these antiproteinuric effects of losartan can be translated to renoprotection.
Chan
J C
JC
Department of Clinical Pharmacology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Critchley
J A
JA
Tomlinson
B
B
Chan
T Y
TY
Cockram
C S
CS
D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000188:drug therapy*; D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004311:Double-Blind Method; D015736:Felodipine / Q000627:therapeutic use*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D007093:Imidazoles / Q000627:therapeutic use*; D019808:Losartan; D008297:Male; D013777:Tetrazoles / Q000627:therapeutic use*
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D007093:Imidazoles; D013777:Tetrazoles; D019808:Losartan; D015736:Felodipine