Abstract | OBJECTIVE: PATIENTS AND METHODS: A total of 136 proteinuric (300-3000 mg/day), valsartan-treated hypertensive patients with blood pressure less than 140/90 mmHg were randomized into three groups to receive placebo, isosorbide dinitrate (30 mg/day), or nicorandil (15 mg/day) for 6 months. RESULTS: The average dose of valsartan given to the patients was similar in the three groups. Creatinine clearance remained stable throughout the study in the three groups. Nicorandil, but not isosorbide dinitrate, significantly reduced proteinuria by 44% after 6 months (P < 0.0001). Urinary endothelin-1 levels significantly decreased after administration of nicorandil (P = 0.002), whereas placebo and isosorbide dinitrate had no effect. Urinary excretion of endothelin-1 was significantly correlated with improvement in urinary protein excretion in nicorandil-treated patients (r = 0.69, P < 0.0001). The urinary excretion of retinol-binding protein decreased after nicorandil administration, probably reflecting an improvement in tubular function. In contrast, the urinary excretion of immunoglobulin G did not change significantly throughout the study in the three groups. Multivariate analysis revealed that proteinuria was only significantly correlated with the use of nicorandil (model adjusted r = 0.35, P < 0.0001). CONCLUSION:
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Authors | Tsung-Ming Lee, Nen-Chung Chang |
Journal | Journal of hypertension
(J Hypertens)
Vol. 27
Issue 3
Pg. 618-25
(Mar 2009)
ISSN: 1473-5598 [Electronic] England |
PMID | 19262229
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Antihypertensive Agents
- Diuretics, Osmotic
- Endothelin-1
- Tetrazoles
- Nicorandil
- Valsartan
- Creatinine
- Valine
- Isosorbide
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Topics |
- Aged
- Antihypertensive Agents
(therapeutic use)
- Case-Control Studies
- Creatinine
(metabolism)
- Diuretics, Osmotic
(therapeutic use)
- Double-Blind Method
- Endothelin-1
(urine)
- Female
- Humans
- Isosorbide
(therapeutic use)
- Male
- Middle Aged
- Nicorandil
(therapeutic use)
- Prospective Studies
- Proteinuria
(drug therapy)
- Tetrazoles
(therapeutic use)
- Time Factors
- Treatment Outcome
- Valine
(analogs & derivatives, therapeutic use)
- Valsartan
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