Is the reno-protective effect of valsartan dose dependent? A comparative study of 80 and 160 mg day(-1).
Whether the reno-protective effect of angiotensin receptor blockers is dose dependent is unknown for the Japanese population. We sought to elucidate the dose-dependent reno-protective effects of valsartan in Japanese hypertensive patients with albuminuria. This was a multi-center, open-label, parallel-group trial. A total of 181 patients were randomized to receive either 80 (n=89) or 160 mg day(-1) (n=92) of valsartan for 24 weeks. Then, the effects on blood pressure, urinary albumin excretion (UAE), type IV collagen and beta(2)-microglobulin (beta2MG) were determined. Systolic and diastolic blood pressures decreased substantially by almost the same extent in the low-dose and high-dose groups, showing no inter-group difference during the treatment. The UAE value decreased significantly by 35% in both groups. Urinary excretion of beta2MG was significantly decreased in the high-dose group (17%), but not in the low-dose group (13%), although the decrease was not significantly different between the two groups (P=0.74). Urinary excretion of type IV collagen decreased non-significantly by 10% in the low-dose group and by 8% in the high-dose group, showing no significant inter-group difference (P=0.78). Low (80 mg day(-1)) and high (160 mg day(-1)) doses of valsartan showed a similar effect of lowering blood pressure. The high dose of valsartan resulted in a slightly greater decrease in urinary beta2MG, but it was inconclusive whether the high dose was more reno-protective as compared with the low dose.
Saikawa
Tetsunori
T
Department of Clinical Examination and Diagnostics, Oita University, Oita, Japan. saikawa@med.oita-u.ac.jp
Sasaki
Jun
J
Biro
Sadayoshi
S
Kono
Suminori
S
Otonari
Takatoshi
T
Ikeda
Yoshiyuki
Y
D000368:Aged; D000419:Albuminuria / Q000188:drug therapy; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D001806:Blood Urea Nitrogen; D024141:Collagen Type IV / Q000652:urine; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000008:administration & dosage*; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000068756:Valsartan; D001613:beta 2-Microglobulin / Q000652:urine
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D024141:Collagen Type IV; D013777:Tetrazoles; D001613:beta 2-Microglobulin; D000068756:Valsartan; D003404:Creatinine; D014633:Valine