Direct comparison of the effects of valsartan and amlodipine on renal hemodynamics in human essential hypertension

Delles, C. , Klingbeil, A.U., Schneider, M.P., Handrock, R., Schmieder, R.E. and Weidinger, G. (2003) Direct comparison of the effects of valsartan and amlodipine on renal hemodynamics in human essential hypertension. American Journal of Hypertension, 16(12), pp. 1030-1035. (doi:10.1016/j.amjhyper.2003.07.017)

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Abstract

Background: To elucidate the renoprotective mechanism of AT1-receptor blockers, we compared the effects of the AT1-receptor blocker valsartan with those of the calcium channel blocker amlodipine on renal hemodynamics and microcirculation.

Methods: A total of 58 patients (50.2 ± 9.0 years) with mild to moderate essential hypertension were included in a randomized, double-blind study to receive either valsartan (80 to 160 mg) or amlodipine (5 to 10 mg). Renal plasma flow (RPF) and glomerular filtration rate (GFR) were measured before and after 8 weeks of treatment. Glomerular hydrostatic pressure (PGlo) and resistances of the afferent (RA) and efferent (RE) arterioles were calculated according to the Gomez formulas.

Results: Blood pressure control was similar in both groups. RPF did not change with either treatment. In contrast, GFR increased with amlodipine (+8 ± 14 mL/min; P < .01) but was preserved with valsartan. Amlodipine caused a more marked increase in the RE/RA ratio than valsartan (+0.26 ± 0.26 v +0.13 ± 0.24, P < .05), which was paralleled by an increase in PGlo in patients treated with amlodipine (+1.9 ± 4.3 mm Hg; P < .05) but not in those treated with valsartan.

Conclusions: At similar blood pressure control, valsartan maintained GFR and PGlo, whereas amlodipine led to glomerular hyperfiltration and an increase in PGlo. The results might explain the favorable renal outcome with AT1-receptor blocker therapy.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Schneider, Dr Markus and Delles, Professor Christian
Authors: Delles, C., Klingbeil, A.U., Schneider, M.P., Handrock, R., Schmieder, R.E., and Weidinger, G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:American Journal of Hypertension
ISSN:0895-7061
ISSN (Online):1941-7225
Published Online:21 November 2003

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