[Evaluation of the effectivenes of treatment of patients with renal arterial hypertension with carvedilol].
The aim of the study was to compare the hypotensive effect and safety of carvedilol, a non-selective alpha-beta blocker, and monopril, an angiotensin-converting enzyme inhibitor (ACEi), in patients with arterial hypertension and a chronic renal disease. The main group (MG), 26 patients, was treated with carvedilol, which was administered as a hypotensive agent instead of the ACEi. The control group (CG) included 24 patients on a "standard" therapy with hypothiazide 12.5 mg a day, amlodipine 10 mg a day, and monopril 20 mg a day. Patients who received carvedilol displayed an earlier hypotensive effect (HE). Together with HE realization, the patients of both groups displayed a moderate increase in glomerular filtration (not more than by 10 ml/min), and an increase in creatinine blood level (not more than by 15%) during the first two weeks, which can be explained by a decrease in intraglomerular hypertension. A significant decrease in total cholesterol level and a more pronounced regress of left ventricular myocardial hypertrophy were noticed in the MG vs. the CG. Measurement of the serum levels of cortisol, aldosterone, and angiotensin I showed that the patients of the MG displayed a significant decrease in aldosterone level together with a clear tendency of cortisol level increase. The concentrations of these hormones in CG patients did not change significantly. The result demonstrate that prolonged administration of carvedilol leads to a noticeable decrease in the serum level of aldosterone, an increase in cortisol level, and electrolyte changes, such as an increase in sodium level and a decrease in potassium level in blood plasma.
Rakov
A L
AL
Nikitin
A V
AV
Riabov
A Iu
AIu
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D005260:Female; D017328:Fosinopril / Q000627:therapeutic use; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000175:diagnosis; D006977:Hypertension, Renal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D011412:Propanolamines / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D011412:Propanolamines; D014665:Vasodilator Agents; D000077261:Carvedilol; D017328:Fosinopril