2001 Volume 24 Issue 2 Pages 153-158
The aim of this study was to compare the effects of an angiotensin-converting enzyme (ACE) inhibitor and αβ blocker in combination with a calcium antagonist on the progression of renal function and left ventricular hypertrophy (LVH) in patients with chronic renal insufficiency and hypertension. The 65 subjects in this study were recruited from a cohort of 316 patients. The main criteria for inclusion were echocardiographic diagnosis of LVH (posterior wall thickness >12 mm) and serum creatinine of more than 1.5 mg/dl. Antihypertensive treatments were switched to the combination of amlodipine at a dose of 5 mg and benazepril at a dose of 2.5 mg daily or the combination of amlodipine at a dose of 5 mg and arotinolol at a dose of 20 mg daily at random irrespective of whether or not patients had been previously treated. The follow-up period was 2 years. Systolic and diastolic blood pressure were significantly reduced from 150/90±15/11 mmHg to 130/75±11/9 mmHg (ACE) and the levels of serum creatinine were increased significantly from 1.8±0.3 to 2.0±0.4 mg/dl (ACE). In the αβ-blocker group, these two values were similar and no significant changes were found. PWT was decreased from 14.2±0.6 to 12.9±0.3 cm in αβ blocker but was not significantly decreased in the ACE inhibitor group. In conclusion, combination therapy with a calcium antagonist and αβ blocker might be effective treatment for hypertensive patients with chronic renal insufficiency and left ventricular hypertrophy. (Hypertens Res 2001; 24: 153-158)
