Effects of Lisinopril and Nitrendipine on Urinary Albumin Excretion and Renal Function in Patients with Mild to Moderate Essential Hypertension.

Ogawa, Yasuhiro; Haneda, Takashi; Hirayama, Tomoya; Ide, Hiroshi; Obara, Atsushi; Maruyama, Junichi; Morimoto, Hideo; Tanaka, Hideichi; Kato, Jun; Hayakawa, Takuji; Hasebe, Naoyuki; Kikuchi, Kenjiro

doi:10.1291/hypres.23.607

Cited by 8 publications

(4 citation statements)

References 35 publications

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“…However, when subjects with obesity and/or diabetes were excluded, a significant relationship between microalbuminuria and serum CRP was observed only in men. As several kinds of antihypertensive medications have been reported to reduce urinary albumin excretion in patients with essential hypertension (22,23), analysis was performed after exclusion of subjects taking any antihypertensive medications. The relationship between serum CRP levels and microalbuminuria was persistent.…”

Section: Resultsmentioning

confidence: 99%

Association between Serum C-reactive Protein Levels and Microalbuminuria: A Population-Based Cross-Sectional Study in Northern Iwate, Japan

et al. 2004

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Objective The presence of microalbuminuria is a renal marker of vascular endothelial damage, and is an independent and strong predictor of increased risk for cardiovascular mortality and morbidity. Elevated circulating C-reactive protein (CRP) levels have recently been reported to be a novel cardiovascular risk factor, and it has been suggested that this acute-phase protein impairs vascular endothelial function. The aim of the present study was to determine whether serum CRP level is a dependent or an independent risk factor of microalbuminuria in the general population.Methods Subjects of this cross-sectional study were apparently healthy individuals drawn from the general Japanese population (mean age, 62; men, 2,236; women, 4,217). Serum CRP levels were determined using a highly sensitive kit and urine albumin-creatinine ratio (UACR) was calculated using a single urine sample. Multivariate logistic regression analysis was used to determine which risk factors (ie, age, hypertension, diabetes, obesity, hypercholesterolemia, smoking, and CRP) might predict the presence of microalbuminuria.Results In addition to classical cardiovascular risk factors such as age, hypertension, diabetes and obesity, serum CRP levels are also significantly correlated with microalbuminuria in men (odds ratio=1.42, 95% CI= 1.13-1.79; p<0.01) and women (odds ratio=1.25, 95% CI=1.05-1.49; p<0.01). When subjects with diabetes were excluded from the analysis, serum CRP levels continued to be a significant predictor for microalbuminuria (odds ratio=1.35, 95% CI=1.06-1.73; p<0.05 for men: odds ratio=1.23, 95% CI=1.03-1.47; p<0.05 for women). ConclusionsThe present study has shown that lowgrade inflammation as represented by high sensitivity CRP levels may be significantly related to the presence of microalbuminuria. This suggests that microalbuminuria may be a useful marker representing systemic low-grade inflammation as well as being an established cardiovascular risk factor in apparently healthy individuals.

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Section: Resultsmentioning

confidence: 99%

Association between Serum C-reactive Protein Levels and Microalbuminuria: A Population-Based Cross-Sectional Study in Northern Iwate, Japan

et al. 2004

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“…Hypertension prevalent in the Japanese population is a significant predictor of renal disease (25), and some antihypertensive medications are reported to exert favorable effects on renal function (26,27). In addition to medical therapies, cardiologists can play an important role in renal artery revascularization treatment (28) because CAD is often associated with RAS, the skills necessary to perform coronary intervention are transferable to the peripheral vasculature (29), and the revascularization of renal arteries may improve hypertension and reduce volume overload.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Renal Artery Stenosis in Patients Undergoing Cardiac Catheterization.

et al. 2002

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Renal artery stenosis (RAS) is recognized as a major co-morbid condition for patients with cardiovascular disease. Although the prevalence of RAS in Western countries has been reported as 13.5-18% in patients with suspected coronary artery disease (CAD) undergoing coronary angiography, there is little information available about the prevalence of RAS in Asian populations, which are less susceptible to atherosclerosis. To evaluate the prevalence of RAS in Japanese patients suspected of cardiovascular disease and the relationships among RAS and vascular risk factors, especially hypertension, renal artery angiography was performed in a total of 289 consecutive patients receiving diagnostic cardiac catheterization. RAS with a stenosis diameter greater than 50% was considered significant. The prevalence of RAS was 21/289 (7%) including 18 (6%) cases of unilateral stenosis and 3 (1%) of bilateral stenosis. RAS accompanied 14/220 (6%) cases of CAD, 4/34 (12%) cases of valvular heart disease and 1/14 (7%) cases of cardiomyopathy. In the subgroups of CAD, the prevalence of RAS was 5%, 10%, 9%, and 19% in cases of 0, 1, 2 and 3-vessel disease, respectively. Hypertension was more frequent among patients with than among those without RAS (86% vs. 45%, p=0.0003). The prevalence of RAS was 13% in hypertensives and 2% in normotensives (p = 0.004). Thus RAS was frequent in patients with established CAD, and particularly in those with 3-vessel disease. Together, the results showed that hypertension was closely associated with RAS, appearing as both a risk factor and a possible clinical manifestation of the disease. We conclude that more attention should be paid to RAS in Japanese patients with hypertension and cardiovascular disease.

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“…105 Further, albeit indirect, evidence for a role of angiotensin II in microalbuminuria development is represented by the stronger anti-albuminuric effect exerted by the ACE inhibitors as compared with other antihypertensive drugs. [42][43][44] Cigarette smoke Similar to type 1 and 2 diabetics, 106,107 non-diabetic smokers, hypertensive or not, tend to excrete more albumin ( Table 5). The first report by Gosling et 114 and may expose to higher risk of morbid events when coexisting with elevated UAE.…”

Section: -99mentioning

confidence: 99%

Microalbuminuria, an integrated marker of cardiovascular risk in essential hypertension

et al. 2002

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This paper reviews the existing epidemiological and clinical evidence about the relationships of non-diabetic microalbuminuria with cardiovascular risk factors such as elevated blood pressure (BP), systolic particularly, cardiac hypertrophy, adverse metabolic status, smoking habits, elevated angiotensin II levels, endothelial dysfunction, acute and perhaps subclinical inflammation. Because of that unique property of reflecting the influence of so many clinically relevant parameters, microalbuminuria may legitimately be defined as an integrated marker of cardiovascular risk, an unique profile among the several prognostic predictors available to

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Effects of Lisinopril and Nitrendipine on Urinary Albumin Excretion and Renal Function in Patients with Mild to Moderate Essential Hypertension.

Cited by 8 publications

References 35 publications

Association between Serum C-reactive Protein Levels and Microalbuminuria: A Population-Based Cross-Sectional Study in Northern Iwate, Japan

Association between Serum C-reactive Protein Levels and Microalbuminuria: A Population-Based Cross-Sectional Study in Northern Iwate, Japan

Prevalence and Predictors of Renal Artery Stenosis in Patients Undergoing Cardiac Catheterization.

Microalbuminuria, an integrated marker of cardiovascular risk in essential hypertension

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