Amlodipine Therapy Corrects Renal Abnormalities Encountered in the Hypertensive State

Reams, Garry P.; Lau, Alisa; Hamory, Ann; Bauer, John H.

doi:10.1016/s0272-6386(87)80191-9

Cited by 46 publications

(13 citation statements)

References 18 publications

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“…[33][34][35][36][37][38][39][40][41][42] Therefore, a negative correResearch Council (12-2008-1). JSJ was a research lation between UAER and effective BP treatment fellow of the Danish Heart Foundation.…”

Section: Acknowledgementsmentioning

confidence: 99%

Microalbuminuria and its relation to cardiovascular disease and risk factors. A population-based study of 1254 hypertensive individuals

Feldt‐Rasmussen

Borch‐Johnsen

et al. 1997

J Hum Hypertens

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Microalbuminuria has been proposed as a potential jects were characterized by higher age and systolic BP, and a male predominance, as compared to normoalbumatherosclerotic risk factor in hypertensive individuals. The aim of this cross-sectional population study was to inuric hypertensive subjects. urinary albumin excretion than insufficiently treated or untreated participants. It is concluded that slightly elevparticipants without diabetes mellitus or renal/urinary tract disease had arterial hypertension. Age range was ated albumin excretion in the urine is not only a pressure-dependent functional phenomenon in the glomeru-30-70 years. Microalbuminuria (nocturnal urinary albumin excretion Ͼ15 g/min) occurred in 5%, and cardiolar vessel walls, but associated with permanent atherosclerotic abnormalities in the entire vascular vascular disease (previous acute myocardial infarction or electrocardiographic Q-waves) also in 5% of the system. study population. Microalbuminuric hypertensive subKeywords: acute myocardial infarction; antihypertensive agents; arterial hypertension; atherosclerotic risk factors; cardiovascular disease; microalbuminuria; urinary albumin excretion it is not known whether prevention of cardiovascu-

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Section: Acknowledgementsmentioning

confidence: 99%

Microalbuminuria and its relation to cardiovascular disease and risk factors. A population-based study of 1254 hypertensive individuals

Feldt‐Rasmussen

Borch‐Johnsen

et al. 1997

J Hum Hypertens

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“…26 Consequently, the serum uric acid decrease is likely caused by amlodipine itself. This particular effect may be associated with the natriuretic and kaliopenic effect of the drug documented by Reams et al 27 The tubular mechanism by which it occurs requires additional studies.…”

Section: -24mentioning

confidence: 90%

Antihypertensive effect of amlodipine and lack of interference with cyclosporine metabolism in renal transplant recipients.

et al. 1994

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The catabolism of various calcium channel blockers through cytochrome P-450 is heterogeneous and may be modified by concomitant use of cyclosporin A. In an open study we investigated the antihypertensive effect and clinical tolerance of the dihydropyridine amlodipine and its effects on cyclosporine kinetics in stable hypertensive renal transplant recipients not taking corticosteroids. Ten adult hypertensive patients grafted for 21.4±8.9 months and well stabilized with normal renal function were included in the study. Renal artery stenosis was ruled out by normal Doppler echography. After 2 weeks of placebo, amlodipine was started at a daily dose of 5 mg. The dose was then adjusted to 10 mg if necessary. Blood and urine chemistries and whole-blood cyclosporine trough levels were measured weekly. Cyclosporine kinetics were determined on a hourly basis before amlodipine administration and after 4 weeks of treatment. Normal blood pressure was obtained with the use of 5 mg/d amlodipine in 7 patients and 10 mg/d in 3, diastolic blood pressure decreasing from I n the transplanted patient treated with cyclosporine, all drugs that may modulate cytochrome P-450 activities can induce deleterious effects. 13Interference with cyclosporine metabolism induces either an increase of blood cyclosporine levels, and consequently potentiation of cyclosporine nephrotoxicity, or a decrease of cyclosporine levels, with a risk of acute rejection. Among the various drugs that interfere with cyclosporine metabolism are some members of the calcium channel blocker family, which are particularly efficient in treating the hypertension that occurs in more than 80% of transplant recipients. Diltiazem, 4 verapamil, 5 and nicardipine 67 increase cyclosporine levels by competitive inhibition of cytochrome P-450 activities, 8 whereas other calcium channel blockers, such as nifedipine, 9 nitrendipine, 10 and isradipine, 11 do not interact with cyclosporine significantly.We undertook the present study in the hypertensive renal transplanted patient on cyclosporine without cor- 98.7±3.8 to 81.3±9.1 mm Hg (/ > =.0007). Heart rate slightly increased by 10% (P<.02). The drug was well tolerated, and only minor ankle edema was found in 3 patients. Cyclosporine doses were not modified and cyclosporine levels remained unchanged throughout the study. Cyclosporine kinetic parameters were not significantly different at the beginning and end of the study. Bioequivalence was demonstrated indicating that cyclosporine biotransformation was not altered by the concomitant administration of amlodipine. We conclude that amlodipine at the dosage of 5 to 10 mg/d is an efficient calcium channel blocker in hypertensive renal transplant recipients treated with cyclosporine without corticosteroids. Moreover, amlodipine does not interfere with cyclosporine diffusion and metabolism. 12 Our goals were (1) to test the antihypertensive effect and tolerance of the drug given as unique antihypertensive therapy and (2) to detect any change in cyclosporine kinetics in the part...

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“…Since the filtration fraction was unchanged in the previous studies with calcium channel blockers (Sunderrajan et al 1986 ;Reams et al 1987), it has been assumed that the increase in glomerular filtration rate and effective renal plasma flow may be related predominantly to the decrease in afferent arteriolar resistance. These assumption would be responsible for the differences in the outcome of angiotensin converting enzyme inhibitors and calcium channel blockers treatments in their renal effects.…”

Section: Discussionmentioning

confidence: 99%

Effects of antihypertensive drugs on renal function and atrial natriuretic polypeptide in spontaneously hypertensive rats with renal ablation.

Yasujima

Abe

Kanazawa

et al. 1989

Tohoku J. Exp. Med.

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Amlodipine Therapy Corrects Renal Abnormalities Encountered in the Hypertensive State

Cited by 46 publications

References 18 publications

Microalbuminuria and its relation to cardiovascular disease and risk factors. A population-based study of 1254 hypertensive individuals

Microalbuminuria and its relation to cardiovascular disease and risk factors. A population-based study of 1254 hypertensive individuals

Antihypertensive effect of amlodipine and lack of interference with cyclosporine metabolism in renal transplant recipients.

Effects of antihypertensive drugs on renal function and atrial natriuretic polypeptide in spontaneously hypertensive rats with renal ablation.

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