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 ORIGINAL ARTICLE
Year : 2010  |  Volume : 20  |  Issue : 1  |  Page : 15-20

Effect of amlodipine and lisinopril on microalbuminuria in patients with essential hypertension: A prospective study


1 Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
2 Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
3 Department of Nephrology, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India
4 Department of Immunology and Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar, Kashmir, India

Correspondence Address:
F A Sofi
Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, (SKIMS), Soura, Srinagar - 190 011, Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.62090

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Microalbuminuria can be present in 25-100% of patients with essential hypertension and is associated with increased incidence of cardiovascular events. Our goal was to evaluate the effect of a commonly used calcium channel blocker, amlodipine, and an angiotensin converting enzyme inhibitor, lisinopril on urinary albumin excretion in patients with mild to moderate essential hypertension. We screened 324 patients with essential hypertension for microalbuminuria and documented it in 120 patients. These 120 patients with microalbuminuria were randomly divided into two groups of 60 each, matched for age, sex, arterial pressure, creatinine clearance, and urinary albumin excretion so as to receive amlodipine or lisinopril. We prospectively measured their urinary albumin excretion and creatinine clearance prior to treatment and, four and eight weeks after treatment with amlodipine or lisinopril. Mean arterial pressure (mean±SD) at baseline, after four weeks, and after eight weeks was 113.01±4.38, 104.93±3.12, and 98.89±1.75 mmHg ( P < 0.0000); and 114.13±7.11, 106.52±3.50, and 100.89±2.80mmHg ( P < 0.0000) in amlodipine and lisinopril groups, respectively. Urinary albumin excretion (mean ± SEM) at baseline, after four, and after eight weeks was 79.30 ± 3.74, 62.03 ± 3.61, and 52.02 ± 3.05 ( P < 0.0000); and 73.96 ± 4.10, 72.39 ± 3.74, 66.12 ± 3.94 ( P = 0.1742) in lisinopril and amlodipine groups, respectively. Lisinopril but not amlodipine, reduced the urinary albumin excretion significantly despite their similar antihypertensive efficacy. The clinical and prognostic significance of these observations need to be established.






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Indian Journal of Nephrology
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