title: Doxazosin GITS trough to peak ratio and 24-hour blood pressure monitoring in the management of hypertension in renal transplant patients.
abstract: We have studied 20 patients, 10 male, 10 female, mean age 52.5+/-10.9 years, who received a cadaver kidney transplant between June 1996 and January 1999. The patients presented with mild or moderate high BP and were treated on a maintained immunosuppression with an anti-calcineurin agent and steroids, associated or not to mycophenolate-mofetil. At baseline, a 24-hour ambulatory BP monitoring was performed. General biochemical parameters were determined and doxazosin GITS (Gastro-Intestinal Therapeutic System) in a single dose of 4 mg/d was started. Doxazosin GITS was titrated four weeks after up to 8 mg/d if the BP was greater than 140/90 mm Hg. At week 12, biochemical analysis were repeated as well as the 24-hour BP monitoring and the T/P ratio was calculated.
  
  
  RESULTS
  The patients were divided in responders, T/P index >50%, n=10 or not-responders, T/P index <50%, n=10 patients). No differences in systolic BP (SBP), diastolic BP(DBP), plasma creatinine or proteinuria were seen at base-line. DBP was lower in responders than in non-responders (P=ns). Doxazosin doses were 5.5+/-3 mg/d vs 5.8+/-3 and T/P ratio 0.70+/-0.13 vs 0.17+/-0.14, (P=.001). There were no variations in pl. t. cholesterol, triglycerides, glucose or uric acid.
  
  
  CONCLUSIONS
  Treatment was safe and efficient, not increasing metabolic adverse effects. Doxazosin GITS is a safe agent which can reduce cardiovascular risk. In our patients, the good T/P ratio has been associated with a best diastolic BP control. This good profile should be taken into account for 24-hour BP control in hypertensive renal transplant patients.
authors.affiliation: Nephrology Department, Hospital de Bellvitge, CSUB, Hospitalet Llobregat, Universitat de Barcelona, Barcelona, Spain. amcastel@terra.es
authors.forename: A
authors.initials: A
authors.lastname: Martínez Castelao
authors.forename: M
authors.initials: M
authors.lastname: Ibernón
authors.forename: X
authors.initials: X
authors.lastname: Sarrias
authors.forename: V
authors.initials: V
authors.lastname: Sanz
authors.forename: F
authors.initials: F
authors.lastname: Moreso
authors.forename: I
authors.initials: I
authors.lastname: Rama
authors.forename: J M
authors.initials: JM
authors.lastname: Grinyó
mesh_terms: D000959:Antihypertensive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D017292:Doxazosin / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy
chemical_list: D000959:Antihypertensive Agents; D017292:Doxazosin