title: Long-term effects of calcium antagonists on augmentation index in hypertensive patients with chronic kidney disease: a randomized controlled study.
abstract: BACKGROUND
  Our previous retrospective study showed that benidipine was superior to amlodipine (AM) for reducing proteinuria and preserving the augmentation index (AI) in patients with chronic kidney disease (CKD).
  
  
  METHODS
  The present study enrolled CKD patients whose blood pressure was not well controlled by an angiotensin receptor blocker (ARB) and a calcium channel blocker other than AM or azelnidipine (AZ). Either AM (5 mg) or AZ (16 mg) was prescribed randomly. Clinical parameters, including proteinuria, serum creatinine, and AI, were measured before initiation of AM or AZ and 1 year later to assess the long-term effect on renal function and central blood pressure.
  
  
  RESULTS
  Brachial and central blood pressures were similarly reduced in both groups. However, pulse rate increased in the AM group, but decreased in the AZ group (+3 ± 1 vs. -2 ± 1 bpm, p < 0.0001). The reduction of proteinuria was greater in the AZ group (-29 ± 2 vs. -38 ± 3%, p < 0.01). Improvement of AI adjusted for a pulse rate of 75 bpm was larger in the AZ group than in the AM group (-4 ± 1 vs. -9 ± 1%, p < 0.05). In both groups, estimated GFR remained unchanged throughout the observation period.
  
  
  CONCLUSIONS
  In hypertensive patients with CKD, combined treatment with AZ and an ARB decreases proteinuria and preferentially improves arterial reflection.
authors.affiliation: Department of Nephrology, Saitama Medical University, Faculty of Medicine, Moroyama, Japan. takenaka @ saitama-med.ac.jp
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takenaka
authors.forename: Takeru
authors.initials: T
authors.lastname: Seto
authors.forename: Mika
authors.initials: M
authors.lastname: Okayama
authors.forename: Eriko
authors.initials: E
authors.lastname: Kojima
authors.forename: Yuka
authors.initials: Y
authors.lastname: Nodaira
authors.forename: Keita
authors.initials: K
authors.lastname: Sueyoshi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kikuta
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Inoue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takane
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ohno
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001383:Azetidinecarboxylic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy*; D013995:Time
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D017311:Amlodipine; D001383:Azetidinecarboxylic Acid; C061679:azelnidipine