Albumin excretion rate and metabolic profile in patients with essential hypertension: effects of isradipine treatment

Background and Aim. Both hyperinsulinaemia and increased urinary albumin excretion rate have been linked to the risk of renal and vascular complications in hypertensive patients. In view of the goal to achieve improved cardiovascular protection, the ability of antihypertensive agents to beneficially modify these novel risk markers needs to be studied. Therefore our aim was to study the effect of isradipine on albumin excretion rate and metabolic profile, and to evaluate possible associations between these parameters in essential hypertensive patients with normal renal function and glucose tolerance. Methods and Results: A randomized, double-blind placebo-controlled study with isradipine (2.5 - 5 mg/d) for 12 weeks was performed in 26 essential hypertensive patients whose diastolic blood pressure (DBP) was between 95 - 114 mmHg. Before and after treatment with isradipine (n = 13) or placebo (n = 13) plasma glucose and insulin levels were measured during glucose tolerance test along with plasma lipid profile, urinary albumin excretion rare, S-creatinine and U-creatinine excretion, Treatment with isradipine, but not with placebo resulted in significant (p = 0.001) decreases in albumin excretion rate and in U-albumin-creatinine ratio (p = 0.002) in addition to BP reduction (p < 0.01). Isradipine-induced changes in albumin excretion rate were related to after treatment fasting glucose (r = 0.573, p = 0.039) and to the change in plasma cholesterol (r = 0.560, p = 0.046), although no major modifications in glucose matabolism and plasma lipids were detected. Conclusion: Isradipine treatment reduced albumin excretion rate in essential hypertensive patients without significantly affecting metabolic profile, The results also support associations between metabolic parameters and markers of renal function in uncomplicated essential hypertensive patients, pointing to the need to consider these related aspects in anti-hypertensive treatment, in addition to effective BP control. (C) 1997, Medikal Press.