Addition of Aliskiren to Angiotensin Receptor Blocker Improves Ambulatory Blood Pressure Profile and Cardiorenal Function Better than Addition of Benazepril in Chronic Kidney Disease

International Journal of Molecular Sciences

Masato Ohsawa²  Kouichi Tamura¹  Tomohiko Kanaoka²  Hiromichi Wakui²  Akinobu Maeda²  Toru Dejima²  Kengo Azushima²  Kazushi Uneda²  Ryu Kobayashi²  Yuko Tsurumi-Ikeya²  Yoshiyuki Toya²  Tetsuya Fujikawa² 

[1] Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan;

关键词: albuminuria;    ambulatory blood pressure;    direct renin inhibitor;    left ventricular hypertrophy;    hypertension (kidney);   

DOI  :  10.3390/ijms140815361

来源: mdpi

【 摘 要 】

An altered ambulatory blood pressure (BP) and heart rate (HR) profile is related to chronic kidney disease (CKD) and cardiorenal syndrome. In this study, we examined the effects of aliskiren, when added to angiotensin II type 1 receptor blockers, on ambulatory BP and cardiorenal function in CKD. Thirty-six hypertensive CKD patients were randomly assigned to the aliskiren add-on group (n = 18) or the benazepril add-on group (n = 18). Ambulatory BP and cardiorenal function parameters were measured at baseline and 24 weeks after treatment. Compared with the benazepril group, nighttime systolic BP variability in the aliskiren group was lower after treatment. Albuminuria was decreased in the aliskiren group, but not in the benazepril group. In addition, left ventricular mass index (LVMI) was significantly lower in the aliskiren group than in the benazepril group after treatment. In the aliskiren group, multivariate linear regression analysis showed an association between changes in albuminuria and changes in nighttime systolic BP. Furthermore, there were associations between changes in LVMI and changes in daytime HR variability, as well as between changes in LVMI and changes in plasma aldosterone concentration. These results suggest that aliskiren add-on therapy may be beneficial for suppression of renal deterioration and pathological cardiac remodeling through an improvement that is effected in ambulatory BP and HR profiles.

【 授权许可】

CC BY   
© 2013 by the authors; licensee MDPI, Basel, Switzerland