The calcium channel blocker controversy in patients with diabetic nephropathy: Is there an issue?

被引：0
作者：
Ruilope L.M. [1 ]
Campo C. [1 ]
Segura J. [1 ]
机构：
[1] Unidad de Hipertensión, Servicio de Nefrologia, Hospital 12 de Octubre, Madrid
来源：
Current Hypertension Reports | 2001年 / 3卷 / 5期
关键词：
Proteinuria; Diabetic Nephropathy; Calcium Channel Blocker; Amlodipine; Angiotensin Converting Enzyme Inhibitor;
D O I：
10.1007/s11906-001-0060-4
中图分类号：
学科分类号：
摘要：
Chronic renal failure, proteinuria, and arterial hypertension run in parallel in the presence of diabetic nephropathy. New goal blood pressure levels have been established in diabetic patients: 130/85 mm Hg and 125/75 mm Hg depending on the level of proteinuria being below or above 1 g/d. New and lower threshold blood pressure (>130/85 mm Hg) to initiate pharmacologic therapy is required in the presence of diabetes mellitus in order to facilitate the strict blood pressure control that is required. It must be considered that both renal and cardiovascular protection are obtained with strict blood pressure control, which otherwise seems to require blockade of angiotensin II effects when proteinuria above 1 g/d is present. While awaiting the publication of long-term follow-up studies looking at renal and cardiovascular outcome in diabetic and other nephropathies in which calcium channel blockers are compared with other antihypertensive drugs, calcium channel blockers will remain the drugs needed to attain the expected goal blood pressure in diabetics, both alone (in the absence of microalbuminuria or macroalbuminuria) or in combination, particularly with angiotensin converting enzyme inhibitors. Copyright © 2001 by Current Science Inc.
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页码：419 / 421
页数：2
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共 21 条
  • [11] The PROCOPA study group: Dissociation between strict blood pressure control and fall in proteinuria in primary renal disease: A randomized double-blind trial, J Hypertens, (2001)
  • [12] Epstein M., Calcium antagonists and the progression of chronic renal failure, Curr Opin Nephrol Hypertens, 7, pp. 171-176, (1998)
  • [13] Zucchelli P., Zuccala A., Borghi M., Et al., Longterm comparison between captopril and nifedipine in the progression of renal insufficiency, Kidney Int, 42, pp. 452-458, (1992)
  • [14] Bakris G.L., Copley J.B., Vicknair N., Et al., Calcium channel blockers versus other antihypertensive therapies on progression of non-insulin-dependent diabetes mellitus associated nephropathy, Kidney Int, 56, pp. 1641-1650, (1996)
  • [15] Velussi M., Brocco E., Frigato F., Et al., Effects of cilazapril and amlodipine on kidney function in hypertensive NIDDM patients, Diabetes, 45, pp. 216-222, (1996)
  • [16] Voyaki S.M., Staessen J.A., Thijs L., Et al., Follow-up of renal function in treated and untreated older patients with isolated systolic hypertension, J Hypertens, 19, pp. 511-519, (2001)
  • [17] Agodoa L.Y., Appel L., Bakris G.L., Et al., Effect of ramipril vs amlo-dipine on renal outcomes in hypertensive nephrosclerosis: A randomized controlled trial, JAMA, 285, pp. 2719-2729, (2001)
  • [18] Rodby R.A., Rohde R.D., Clarke E., Et al., The irbesartan type II diabetic nephropathy trial: Study design and baseline patient characteristics, Nephrol Dial Transplant, 15, pp. 487-497, (2000)
  • [19] Kaplan N.M., Clinical Hypertension, (1998)
  • [20] Blood pressure lowering treatment trialist collaboration: Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: Results of prospectively designed overviews of randomised trials, Lancet, 355, pp. 1955-1964, (2000)
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