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D92 Nifedipine gits therapy for hypertension after kidney transplantation
128A
ASH XII ABSTRACTS
AJH-APRIL 1997-VOL. 10, NO. 4, PART 2
D92
D93
NIF3DIPINE GITS T323APY FM 3YP33T2NSION AFTER KIMfY TRANSPLANTATION a 6am. Ltiems, ~ Ed
11. Eeti
Iys~ri-sl. Sksmshl
Mimn 2h1-lln.
Sbs=skdskim, ,Unmd ,A,cs!’tlwr=?!y% :000:5.
,..~%r’-”m ‘it-r ‘lti~ ~r-s t--~~;~ ~~~~o%s. 0[ of .di.’%w’’::m *1* Is ● r% !; ,-.1 f.,,.r+~~ ● \ 1#,:::*::: fi,fd,f,....,m from .nst.ol .f bl ..1.1 blotir b., b.” s’to ,.. ..1 ,no L fsu. t “ltkant .ff.ctinll to blond ,lwmao. *:4 C.,*S “r, h.” ,hl nbctcd 1,1S9# ‘lSaw tr.asplmt. tiao ,.ti ”ts. Tba lmckx. .f ks,.rt”slmm us S4S, 111 ..80., t“ d f’,.’ 11s ,.tl”ts a, 1. ?, 3 w a**t y..rs, ks..rt”. I m 99*. .8*0114 R“ U t. 61> dkk mild t. .der.t.
1. %1. sinks. ALL #revIm* -t14p.rt”s1a
mdlcmtiwu els.08t1ud tk ,t.rt .: * S:*. blad A .f ● *S-S# 4 4 114-M d SSsteL1. bid ● r..nr. ● t tb9 d of 418md1..i1mm 99*. t8b” w .rlt.rl. of * 1*M. tr..tm”t with N1fodl,l.. for *tads “try. The iaratlm .f ,ctl.. SITS “, fnl Wnk,. Th. inlti.1 SOS, ,Iw” w ak, EIlfdl 1m. do... alTC ●s ● -Ally Aft.* 8 -mk9 of tr..bmut .lfk s*. Wlfdl,lm. GIM. ,.tl”*s ●ot r., 09’1., to I’1* tin ,.,1,...1”4 6b, . . . amo-d. lly 4.s. 0, . fmrrh,r s “c’, tr.. tm”t. ‘“’p-r’ ‘0 Ssq Nif.A@l” ‘#s c.am,,mmd,0 ,x *O ,-0 b,. uatll ** d . Ii, .*. ~,e.~~:~:, ---* .f utl.. tr.g8L8t* SS?S S5? w ..*ObY]omsw bcr..sod. .s .r.. tl.l” C1..,UC. 1..,..s4 At b’. d .f Un”?%y Sss p.tl”t. r. U to NlfcS1pl.. CITS. -%LLd wlfb 3-, d SOS.it &’&r*%’%&:?ff%: ~:! r.,o&d&tk. ,mtl-ts. (Tsb La) ● cf W+*1* fblfd l.. 61TS --d.lly %&Jod m.”. fiz.tlom of b,d ,,.,,.,. 1. d ,1”s ,dl ”ts .ft.r klti.y Irmms,l”tmlnm R::, b,oo4 ,4,...., r-., f“c,,~ -,. ,mp%*%: Nlfdlplm WfS c“ 10N. tk. blood pr..s.r. d ..s ksw . ~~~l.!~ct~f~!.t ~ tk. Musolutmtlu klti.s d cu Imxov. b.f.r.
●r....r.
b.s.li” SIttl., dl”t.~1.
1. d.,. ,x.
~y~or,j~:
hlm,mTwlwOs&T:L
4*”’’-”-
WHICHURINARYPROTEJNSARE DECREASEDAFTER ACE INHIBITTON? GuiddL;Gigfioni A C’),CuzziMG and MirrettiEE Centrndi RicercaClinica irrNeikdogia - UO diNefmlogia, Dialiei e Trspisnto n Istit.to di Ficiol@s Clinica CNR, Oepedale Nigusrds Ca’Granda, Mihmo, Italy ACE Inhibitors (ACEIa) lnwer pmteinuria in easentid bypertcnsion and in glomemlar nephropathies, Since : 1) Pmteinuria ia one of the majorpredictor ofchmnic renal failure progression; 2) The meet abundant protein in normal human urine ie the tub.lsr Tmnm-Horsfallglympmtein (’HIP),and 3) It icbeliwed that ACEIS act nn glomendar hemodynrmriceand thue on excretion of plasma proteins such as albumin, our working bypothesic was that ACEIe rould determine a d-se ofurirmry exeretion of Albumin, but not of THP. We measured urinmy prct.cin excretion by Phaet System, a method baeed on ultrathin semiaut.omated SDS polyserylsmide gel electmphoresia with ailver etaining, in 15 escential hyperterrsives, sfter at least 4 weeks &wash-out fmm any drug and after 2 morsthe on averaga of ACE inhibitinn with oral Quinapril (dcee range 5-20 mg, once daily). After ACE inhibition, bcdy weight, plasma glucose, plssma and urinary creatinine, urste and elactmlytes snd creatinine clearance, wera nnt ditTerentfmm baeeline vrduee.Plsama ACE activity and DBP decreaeed (76i7 + l&t4 U/ml, meaniSEM, 2 tails paired t test, p=O.0001and 96i3 -b Wkt2mmHg, P=O.04rce.pectively)while plasma wea incmaaed (3&2 + 3&2 mg/dL, p=0,02). Bnth albumin snd THP urinary excretions deereased (5M6 + 43*4 mg/24 h, p=O.05snd 1W3 + 12il mg/24 h, p=O.02reapeetively). This unexpected result suggwts that Quinapril may act alao at the Iwel ofrensf tubulnr cella, It remains to be eeen ifthie is a clam effact or it ia aasocisted to come phsmramdynamic pscrdisrity of this drug. Ksy Words: ACE Inhibitors, Albuminrrris,Tamm.Horafsll glyccprvteiff
D94
D95
ADOITfVE ANTIHYPERTENStVE EFFECTS OF ORAL CALCIUM SUPPLEMENTATNIN TO OOXA20SfN IN THE POSTMENOPAUSAL HYPERTENSIVE WOMEN: ASINGLE4LIND, PtACES040NTROLLE0 SNOY. P. Aranda. F,J.Armda, P.J. Arcn&, A. Fcrnandez-LLebrez,E. LDPSZdCNwdss J. Ruiz-A!amlno HypertensionUnitHos#d Rcgiond Carlo6 Haya f#alcgc.Spain. wmen (PHW), hypcrckrdcclerdwniaarid ln~~~ hywcatoiuria are very common bbdwmkal fi~ings, These wow aISCSAW a pathophysiofcgicalpmfik appmpate fcf @ttmg a BP reduction vim oral Cal+ ~,whbhmcybctothcafftihypcrtensiv eagcntc In asingktiind, ~rolled, randomizedsurvey we lncl.dsd40 untreatedmild-mcdemte(DBP: ag+Of%.2* 2.4years0bd, mean SMI: Z,7 S@405mmt?g)es5w+zAPhWwIamean ?4.3aIfrram caauclBP: 172 t 12/ 1022 t 6.3 mmHg forwaluctingtfe cddhiw andnwtakck dfedsofb.xin plus Ca’+suppknwntatbn (D+caz~. amy@amhe Stixtyc!esign:ARer 15day3wshad’s pedcd dlthewfien tcsfcttedwifh Omcmsm 2 mg 00; One month fder in a randunizeL, single-b!indwayvcfsus pksab a hdfof .3f Im mg Ca=ement (acca=ca rbonme)dalfyeumlg mamaMedasl ~ BMI and c+wud BPand HR nwdhiyduriw 3nwrd!s AkUAri ~,wemeawed the4mwAhsoffolknwp CSWII a6a24h ABPM cfttm imlwion andtheendofthsthe fmtmdkwfhnmth Attiw6anw~, wakodetermimd fasten kvesofglwwse, insulin, uric ccid, Weatinina,t-chdederol, trigixaddes and Iirmpmteiw and in 24h
COMPARISONOF THE EFFICACY OF EPROSARTANAND ENALAPRILIN PATIENTSWITH SEVERE HYPERTENSION. c. P onticeu on behalfof the EprmartanStudyGroup, Maggiore Hospital, Milan, Itsly Eprosartmis a novel,non-biphenyl,Wmzoleangiotensin11receptor amcgonist.The smihypcrtensiveefficacyofeprosamsn(200-400mg twicedaily)andemtfapril(10-40mg onc6daily)wcrccompsredin a 10-week,randomized,double-blind,dosetiwdionstudyin patients with severehyp~W3SiDn (sitting diastolicBP(DBP)115-125mmHgat baseline. Patientswererandomizedto eitherepmssmn 200mg twicedcily or enafamil10mi!oncedaily. Thereafter.at two-wreklvintervals.dos could”beuptitr~tcd(dependingon BP r&mrse). Ifp&ientswere receivingthehighestavailabledoseof studymedicationwithout achievingtargetresponse,25 mg hydmchlorothiazide(HCTZ)once dailywas added, Thepropmtionofpatienb thatrcc.civedHCTZwas simihuin bd groups. Bloodpressurewas mc.wurcdat tiough. Antihypcrtensiveeffectwm assessedas meanchangesfrombaselinesndrcsponsemte (definedas percentageofpatients whosesittingDBPdecreasedto< 90 mmHgor decrea.scd frombaselineby215 mmHg)at StudyEndpoint.
-.
RSStdta
O.OM:-LXO. O1:... %<
D <0.0S.Nc4~ Cimmoanf chmmcin SW. HR. ard D+P:m; showed an addnlw Colrckfsimm: mxcsc#m piuc C4al cc” su@m@atbn dhy@m&a Cffecfwsh a fpd Chlkal tcbmwca. Ol?dc&sup#ewfwm also cd Inmcmed thewStkry Na+ ImfOsmwtiwbe$mfwa I ~ic6ffcci80f00mwain Cxcmtim
&3f0ifnioikflekl&l piansbn MNd81dMff6C6(%) D+Ca%.
J@2m@U3EUtlS@l 59 59 Asittingdiastol~ BP (mmHg) -20.1* 2.1 -16.2*2.O AsittingsystolicBP (mmHg) -29.1i 2.9 -21.1+ 2.7* AstandingdiastolicBP (mmHg) -19.1* 2.0 -14,7* 1,9 A standingsystolicBP (mrnHg) -27.8+3.0 -20.0+ 2.7* Respmwerate(%) 69.5 54.2 * p <0.05 Conclusion: Subsfmrtisl,clbdcaflysignifiantdecrs assc in blood pressurewers cchicvcdwirb both mcdicarions. ~pmsartaoproducedgrsatsrrcductionsin BP than e-l, the differsncosbsingstatisticallysignificant for reductionsin systolicBP.
Ksy words:
Sevcrehypertcnsion,sprossrtsn,rmlapril.
ASH XII ABSTRACTS
AJH-APRIL 1997-VOL. 10, NO. 4, PART 2
D92
D93
NIF3DIPINE GITS T323APY FM 3YP33T2NSION AFTER KIMfY TRANSPLANTATION a 6am. Ltiems, ~ Ed
11. Eeti
Iys~ri-sl. Sksmshl
Mimn 2h1-lln.
Sbs=skdskim, ,Unmd ,A,cs!’tlwr=?!y% :000:5.
,..~%r’-”m ‘it-r ‘lti~ ~r-s t--~~;~ ~~~~o%s. 0[ of .di.’%w’’::m *1* Is ● r% !; ,-.1 f.,,.r+~~ ● \ 1#,:::*::: fi,fd,f,....,m from .nst.ol .f bl ..1.1 blotir b., b.” s’to ,.. ..1 ,no L fsu. t “ltkant .ff.ctinll to blond ,lwmao. *:4 C.,*S “r, h.” ,hl nbctcd 1,1S9# ‘lSaw tr.asplmt. tiao ,.ti ”ts. Tba lmckx. .f ks,.rt”slmm us S4S, 111 ..80., t“ d f’,.’ 11s ,.tl”ts a, 1. ?, 3 w a**t y..rs, ks..rt”. I m 99*. .8*0114 R“ U t. 61> dkk mild t. .der.t.
1. %1. sinks. ALL #revIm* -t14p.rt”s1a
mdlcmtiwu els.08t1ud tk ,t.rt .: * S:*. blad A .f ● *S-S# 4 4 114-M d SSsteL1. bid ● r..nr. ● t tb9 d of 418md1..i1mm 99*. t8b” w .rlt.rl. of * 1*M. tr..tm”t with N1fodl,l.. for *tads “try. The iaratlm .f ,ctl.. SITS “, fnl Wnk,. Th. inlti.1 SOS, ,Iw” w ak, EIlfdl 1m. do... alTC ●s ● -Ally Aft.* 8 -mk9 of tr..bmut .lfk s*. Wlfdl,lm. GIM. ,.tl”*s ●ot r., 09’1., to I’1* tin ,.,1,...1”4 6b, . . . amo-d. lly 4.s. 0, . fmrrh,r s “c’, tr.. tm”t. ‘“’p-r’ ‘0 Ssq Nif.A@l” ‘#s c.am,,mmd,0 ,x *O ,-0 b,. uatll ** d . Ii, .*. ~,e.~~:~:, ---* .f utl.. tr.g8L8t* SS?S S5? w ..*ObY]omsw bcr..sod. .s .r.. tl.l” C1..,UC. 1..,..s4 At b’. d .f Un”?%y Sss p.tl”t. r. U to NlfcS1pl.. CITS. -%LLd wlfb 3-, d SOS.it &’&r*%’%&:?ff%: ~:! r.,o&d&tk. ,mtl-ts. (Tsb La) ● cf W+*1* fblfd l.. 61TS --d.lly %&Jod m.”. fiz.tlom of b,d ,,.,,.,. 1. d ,1”s ,dl ”ts .ft.r klti.y Irmms,l”tmlnm R::, b,oo4 ,4,...., r-., f“c,,~ -,. ,mp%*%: Nlfdlplm WfS c“ 10N. tk. blood pr..s.r. d ..s ksw . ~~~l.!~ct~f~!.t ~ tk. Musolutmtlu klti.s d cu Imxov. b.f.r.
●r....r.
b.s.li” SIttl., dl”t.~1.
1. d.,. ,x.
~y~or,j~:
hlm,mTwlwOs&T:L
4*”’’-”-
WHICHURINARYPROTEJNSARE DECREASEDAFTER ACE INHIBITTON? GuiddL;Gigfioni A C’),CuzziMG and MirrettiEE Centrndi RicercaClinica irrNeikdogia - UO diNefmlogia, Dialiei e Trspisnto n Istit.to di Ficiol@s Clinica CNR, Oepedale Nigusrds Ca’Granda, Mihmo, Italy ACE Inhibitors (ACEIa) lnwer pmteinuria in easentid bypertcnsion and in glomemlar nephropathies, Since : 1) Pmteinuria ia one of the majorpredictor ofchmnic renal failure progression; 2) The meet abundant protein in normal human urine ie the tub.lsr Tmnm-Horsfallglympmtein (’HIP),and 3) It icbeliwed that ACEIS act nn glomendar hemodynrmriceand thue on excretion of plasma proteins such as albumin, our working bypothesic was that ACEIe rould determine a d-se ofurirmry exeretion of Albumin, but not of THP. We measured urinmy prct.cin excretion by Phaet System, a method baeed on ultrathin semiaut.omated SDS polyserylsmide gel electmphoresia with ailver etaining, in 15 escential hyperterrsives, sfter at least 4 weeks &wash-out fmm any drug and after 2 morsthe on averaga of ACE inhibitinn with oral Quinapril (dcee range 5-20 mg, once daily). After ACE inhibition, bcdy weight, plasma glucose, plssma and urinary creatinine, urste and elactmlytes snd creatinine clearance, wera nnt ditTerentfmm baeeline vrduee.Plsama ACE activity and DBP decreaeed (76i7 + l&t4 U/ml, meaniSEM, 2 tails paired t test, p=O.0001and 96i3 -b Wkt2mmHg, P=O.04rce.pectively)while plasma wea incmaaed (3&2 + 3&2 mg/dL, p=0,02). Bnth albumin snd THP urinary excretions deereased (5M6 + 43*4 mg/24 h, p=O.05snd 1W3 + 12il mg/24 h, p=O.02reapeetively). This unexpected result suggwts that Quinapril may act alao at the Iwel ofrensf tubulnr cella, It remains to be eeen ifthie is a clam effact or it ia aasocisted to come phsmramdynamic pscrdisrity of this drug. Ksy Words: ACE Inhibitors, Albuminrrris,Tamm.Horafsll glyccprvteiff
D94
D95
ADOITfVE ANTIHYPERTENStVE EFFECTS OF ORAL CALCIUM SUPPLEMENTATNIN TO OOXA20SfN IN THE POSTMENOPAUSAL HYPERTENSIVE WOMEN: ASINGLE4LIND, PtACES040NTROLLE0 SNOY. P. Aranda. F,J.Armda, P.J. Arcn&, A. Fcrnandez-LLebrez,E. LDPSZdCNwdss J. Ruiz-A!amlno HypertensionUnitHos#d Rcgiond Carlo6 Haya f#alcgc.Spain. wmen (PHW), hypcrckrdcclerdwniaarid ln~~~ hywcatoiuria are very common bbdwmkal fi~ings, These wow aISCSAW a pathophysiofcgicalpmfik appmpate fcf @ttmg a BP reduction vim oral Cal+ ~,whbhmcybctothcafftihypcrtensiv eagcntc In asingktiind, ~rolled, randomizedsurvey we lncl.dsd40 untreatedmild-mcdemte(DBP: ag+Of%.2* 2.4years0bd, mean SMI: Z,7 S@405mmt?g)es5w+zAPhWwIamean ?4.3aIfrram caauclBP: 172 t 12/ 1022 t 6.3 mmHg forwaluctingtfe cddhiw andnwtakck dfedsofb.xin plus Ca’+suppknwntatbn (D+caz~. amy@amhe Stixtyc!esign:ARer 15day3wshad’s pedcd dlthewfien tcsfcttedwifh Omcmsm 2 mg 00; One month fder in a randunizeL, single-b!indwayvcfsus pksab a hdfof .3f Im mg Ca=ement (acca=ca rbonme)dalfyeumlg mamaMedasl ~ BMI and c+wud BPand HR nwdhiyduriw 3nwrd!s AkUAri ~,wemeawed the4mwAhsoffolknwp CSWII a6a24h ABPM cfttm imlwion andtheendofthsthe fmtmdkwfhnmth Attiw6anw~, wakodetermimd fasten kvesofglwwse, insulin, uric ccid, Weatinina,t-chdederol, trigixaddes and Iirmpmteiw and in 24h
COMPARISONOF THE EFFICACY OF EPROSARTANAND ENALAPRILIN PATIENTSWITH SEVERE HYPERTENSION. c. P onticeu on behalfof the EprmartanStudyGroup, Maggiore Hospital, Milan, Itsly Eprosartmis a novel,non-biphenyl,Wmzoleangiotensin11receptor amcgonist.The smihypcrtensiveefficacyofeprosamsn(200-400mg twicedaily)andemtfapril(10-40mg onc6daily)wcrccompsredin a 10-week,randomized,double-blind,dosetiwdionstudyin patients with severehyp~W3SiDn (sitting diastolicBP(DBP)115-125mmHgat baseline. Patientswererandomizedto eitherepmssmn 200mg twicedcily or enafamil10mi!oncedaily. Thereafter.at two-wreklvintervals.dos could”beuptitr~tcd(dependingon BP r&mrse). Ifp&ientswere receivingthehighestavailabledoseof studymedicationwithout achievingtargetresponse,25 mg hydmchlorothiazide(HCTZ)once dailywas added, Thepropmtionofpatienb thatrcc.civedHCTZwas simihuin bd groups. Bloodpressurewas mc.wurcdat tiough. Antihypcrtensiveeffectwm assessedas meanchangesfrombaselinesndrcsponsemte (definedas percentageofpatients whosesittingDBPdecreasedto< 90 mmHgor decrea.scd frombaselineby215 mmHg)at StudyEndpoint.
-.
RSStdta
O.OM:-LXO. O1:... %<
D <0.0S.Nc4~ Cimmoanf chmmcin SW. HR. ard D+P:m; showed an addnlw Colrckfsimm: mxcsc#m piuc C4al cc” su@m@atbn dhy@m&a Cffecfwsh a fpd Chlkal tcbmwca. Ol?dc&sup#ewfwm also cd Inmcmed thewStkry Na+ ImfOsmwtiwbe$mfwa I ~ic6ffcci80f00mwain Cxcmtim
&3f0ifnioikflekl&l piansbn MNd81dMff6C6(%) D+Ca%.
J@2m@U3EUtlS@l 59 59 Asittingdiastol~ BP (mmHg) -20.1* 2.1 -16.2*2.O AsittingsystolicBP (mmHg) -29.1i 2.9 -21.1+ 2.7* AstandingdiastolicBP (mmHg) -19.1* 2.0 -14,7* 1,9 A standingsystolicBP (mrnHg) -27.8+3.0 -20.0+ 2.7* Respmwerate(%) 69.5 54.2 * p <0.05 Conclusion: Subsfmrtisl,clbdcaflysignifiantdecrs assc in blood pressurewers cchicvcdwirb both mcdicarions. ~pmsartaoproducedgrsatsrrcductionsin BP than e-l, the differsncosbsingstatisticallysignificant for reductionsin systolicBP.
Ksy words:
Sevcrehypertcnsion,sprossrtsn,rmlapril.