Bianchi S, Bigazzi R, Baldari G, Campese V M
U.O. di Nefrologia e Dialisi, Spedali Riuniti, Livorno, Italy.
Am J Med. 1992 Nov;93(5):525-8. doi: 10.1016/0002-9343(92)90580-5.
Microalbuminuria can be present in 10% to 40% of patients with essential hypertension and is associated with an increased incidence of cardiovascular events. The effect of commonly used antihypertensive agents on urinary albumin excretion (UAE) has not been well established. The aim of this study was to evaluate the effects of a converting enzyme inhibitor, a calcium channel blocker, a beta blocker, and a diuretic on UAE and on creatinine clearance in patients with mild to moderate hypertension.
We prospectively measured UAE prior to and 4 and 8 weeks after treatment with enalapril, nitrendipine, atenolol, or a diuretic in 48 patients with essential hypertension and microalbuminuria.
All these agents were equally effective in reducing arterial pressure. However, enalapril but not the other agents significantly decreased UAE.
Eight weeks of therapy with enalapril may reduce UAE in patients with mild to moderate essential hypertension, whereas other agents, such as nitrendipine, atenolol, or diuretics, had no measurable effect on UAE. The clinical and prognostic significance of these observations remains to be established.
微量白蛋白尿可见于10%至40%的原发性高血压患者中，且与心血管事件发生率增加相关。常用抗高血压药物对尿白蛋白排泄（UAE）的影响尚未完全明确。本研究的目的是评估一种转换酶抑制剂、一种钙通道阻滞剂、一种β受体阻滞剂和一种利尿剂对轻度至中度高血压患者UAE及肌酐清除率的影响。
我们前瞻性地测量了48例原发性高血压合并微量白蛋白尿患者在接受依那普利、尼群地平、阿替洛尔或利尿剂治疗前、治疗4周和8周后的UAE。
所有这些药物在降低动脉血压方面同样有效。然而，依那普利可显著降低UAE，而其他药物则无此作用。
依那普利治疗8周可能降低轻度至中度原发性高血压患者的UAE，而其他药物，如尼群地平、阿替洛尔或利尿剂，对UAE无明显影响。这些观察结果的临床及预后意义仍有待确定。
