Department of Cardiology, Kagawa-ken Saiseikai Hospital, Takamatsu, Japan.
Clin Drug Investig. 2010;30(10):699-706. doi: 10.2165/11538510-000000000-00000.
High-normal urinary albumin excretion has been reported to have clinical significance with respect to progression of proteinuria and hypertension.
We analysed the effect of cilnidipine (10 mg/day) on morning systolic blood pressure (SBP) and urine albumin-creatinine ratio (UACR) in 16 non-diabetic hypertensive patients with a normal to marginally elevated UACR (mean +/- SD 29.4 +/- 21.7; range 7.5-72.9 mg/g creatinine).
Sequential home BP and UACR data were fitted to a simple exponential function as follows: where y is SBP (mmHg) or UACR (mg/g creatinine); alpha is the extent of the SBP (mmHg)- or UACR (mg/g creatinine)-lowering effect; beta (days) is the time-constant for SBP or UACR decrease; t is the number of days after the start of cilnidipine administration; and gamma is the finally stabilized SBP (mmHg) or UACR (mg/g creatinine).
Mean +/- SD morning SBP and UACR decreased by 20.4 +/- 11.4 mmHg and 15.2 +/- 13.1 mg/g creatinine, respectively, as determined by coefficient alpha. The mean +/- SD time-constant for UACR decrease was significantly longer than that for BP decrease (43.5 +/- 22.9 vs 15.4 +/- 7.1 days). UACR reduction correlated with pre-treatment UACR values (correlation coefficient [R] = 0.88, p < 0.01) but not with BP decrease.
The present study demonstrated that cilnidipine reduced UACR in hypertensive patients with normal to marginally elevated UACR independent of its BP-lowering effect.
高正常范围的尿白蛋白排泄已被报道与蛋白尿和高血压的进展具有临床意义。
我们分析了西尼地平（10mg/天）对 16 例非糖尿病高血压患者清晨收缩压（SBP）和尿白蛋白/肌酐比值（UACR）的影响，这些患者的 UACR 正常至轻度升高（平均值±SD 29.4±21.7；范围 7.5-72.9mg/g 肌酐）。
将连续的家庭血压和 UACR 数据拟合到一个简单的指数函数中，如下所示：其中 y 是 SBP（mmHg）或 UACR（mg/g 肌酐）；alpha 是 SBP（mmHg）或 UACR（mg/g 肌酐）降低幅度；beta（天）是 SBP 或 UACR 降低的时间常数；t 是开始西尼地平治疗后的天数；gamma 是最终稳定的 SBP（mmHg）或 UACR（mg/g 肌酐）。
通过系数 alpha 确定，平均±SD 清晨 SBP 和 UACR 分别降低了 20.4±11.4mmHg 和 15.2±13.1mg/g 肌酐。UACR 降低的平均±SD 时间常数明显长于 BP 降低的时间常数（43.5±22.9 vs 15.4±7.1 天）。UACR 降低与治疗前的 UACR 值相关（相关系数 [R] = 0.88，p<0.01），但与 BP 降低无关。
本研究表明，西尼地平降低了 UACR 在 UACR 正常至轻度升高的高血压患者中，独立于其降压作用。
