scholarly journals Effect of Combination Therapy with a Calcium Channel Blocker and an Angiotensin-Converting Enzyme Inhibitor on Renal Hypertrophy and Urinary Albumin Excretion in Diabetic Rats

2003 ◽  
Vol 4 (3) ◽  
pp. 191-199 ◽  
Author(s):  
Birgitte Nielsen ◽  
Henning Grønbæk ◽  
Ruth Østerby ◽  
Allan Flyvbjerg
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Urinary Albumin Excretion ◽  
Placebo Treatment ◽  
Diabetic Rats ◽  
Urinary Albumin ◽  
Converting Enzyme ◽  
Albumin Excretion

The objective of this study was to compare the effect of an angiotensin-converting enzyme (ACE) inhibitor and a calcium channel blocker on the development of renal changes in diabetic rats. Diabetes was induced by an intravenous injection of streptozotocin in normotensive Wistar rats. Treatment was commenced immediately in 1 set of rats with 4 treatment arms: nitrendipine (250 mg/kg fodder), enalapril (35 mg/L drinking water), both treatments in combination, or placebo. Treatment was continued for 9 weeks. Another set of rats was left with untreated diabetes for 3 months followed by 7 weeks treatment as above. When starting treatment right after induction of diabetes, nitrendipine significantly reduced urinary albumin excretion (UAE) to the nondiabetic level (P< .05) without reducing blood pressure (BP), whereas enalapril failed to significantly reduce UAE despite a reduction in BP. Combining the two treatments showed no further reduction in UAE compared to monotherapy with nitrendipine, despite a lower BP. When leaving diabetic rats untreated for 3 months, only the coadministration of nitrendipine and enalapril showed a significant reduction in UAE compared to monotherapy and placebo treatment, but showed no significant effect on BP.

Urinary Albumin Excretion and Atherosclerosis in Essential Hypertension

1997 ◽  
Vol 92 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Roberto Pedrinelli ◽  
Klaus Undpaintner ◽  
Giulia Dell'omo ◽  
Vinicio Napoli ◽  
Vitantonio Di Bello ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Angiotensin Converting Enzyme ◽  
Systolic Blood Pressure ◽  
Urinary Albumin Excretion ◽  
Urinary Albumin ◽  
Cardiac Mass ◽  
Converting Enzyme ◽  
Albumin Excretion ◽  
Angiotensin Converting Enzyme Genotype

1. Increased urinary albumin excretion is common in patients with essential hypertension and is at least to some extent correlated with prevailing blood pressure levels. However, the generalized vascular dysfunction present in advanced atherosclerotic disease may independently influence this parameter. 2. To evaluate this possibility, we assessed blood pressure, ultrasonographic carotid thickness, cardiac mass, minimum forearm vascular resistances, metabolic parameters and the angiotensin-converting enzyme genotype in patients with untreated essential hypertension and atherosclerotic peripheral vascular disease (n = 11). The results were compared with similar data obtained in matched groups of patients with uncomplicated hypertension and with normotensive control subjects (n = 11 per group). 3. Urinary albumin excretion was higher in hypertensive patients with atherosclerosis than in those without complications; carotid thickness was higher in atherosclerotic patients and a positive, statistically significant correlation existed between this parameter and urinary albumin excretion. In the same patient group, systolic blood pressure, fasting insulin and triacylglycerol levels were elevated and correlated with urinary albumin levels. However, differences in urinary albumin excretion persisted after taking into account the influence of those parameters by analysis of covariance. The distribution of angiotensin-converting enzyme genotype patterns and values of cardiac mass and minimum forearm vascular resistances did not differ significantly among the experimental groups. 4. The data suggest that vascular status may influence urinary albumin excretion in patients with essential hypertension, while confirming the importance of systolic blood pressure levels as a determinant of the raised urinary albumin excretion.

GAMBARAN PENGOBATAN PASIEN HIPERTENSI DI PUSKESMAS SEYEGAN SLEMAN YOGYAKARTA PERIODE JANUARI-MARET 2018

2018 ◽  
pp. 1-6
Author(s):  
Agustina Susilowati ◽  
Annisa Meylana Wardani
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Beta Blocker ◽  
Ace Inhibitor ◽  
Channel Blocker ◽  
Converting Enzyme

    Hipertensi adalah suatu kondisi dimana terjadi peningkatan tekanan darah lebih bescar dari 90/140 mmHg. Menurut profil kesehatan kabupaten Sleman (2012) penyakit hipertensi menempati peringkat ke dua dari sepuluh besar penyakit rawat jalan. Tujuan dari penelitian ini adalah mengetahui pola peresepan obat hipertensi dan penggunaan obat antihipertensi secara tunggal dan kombinasi obat pada pasien hipertensi di Puskesmas Seyegan Sleman Yogyakarta periode Januari-Maret 2018.    Jenis penelitian ini yaitu deskriptif non eksperimental dengan pengumpulan data rekam medik pasien hipertensi. Data yang diperoleh dianalisis secara deskriptif yaitu menggambarkan dengan persentase, diagram atau tabel.    Hasil penelitian menunjukkan bahwa pola peresepan obat antihipertensi di Puskesmas Seyegan Sleman Yogyakarta adalah golongan diuretik, Calcium Channel Blocker (CCB), Angiotensin Converting Enzyme (ACE) Inhibitor, Angiotensin Reseptor Blocker (ARB), dan Beta Blocker. Penggunaan obat antihipertensi tunggal yang digunakan adalah golongan CCB 66,67%, ACE Inhibitor 6,41%, dan ARB 1,28%. Sedangkan penggunaan obat antihipertensi untuk kombinasi dua jenis 19,24%, kombinasi tiga jenis 6,40%.    Pola peresepan obat antihipertensi yang digunakan di Puskesmas Seyegan Sleman Yogyakarta adalah golongan diuretik, CCB, ACE Inhibitor, ARB, dan Beta Blocker. Penggunaan obat antihipertensi tunggal yang paling banyak digunakan adalah golongan CCB dan untuk obat kombinasi dua jenis adalah golongan CCB dengan ACE Inhibitor.

Abstract 379: Insulin Attenuated Albuminuria by Upregulating Angiotensin Converting Enzyme 2 (ACE2) in Type 1 Diabetic Akita Mice

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Esam Salem ◽  
Hari K Somineni ◽  
Harshita Chodavarapu ◽  
Mariana Morris ◽  
Khalid M Elased
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Urinary Albumin Excretion ◽  
Renin Angiotensin System ◽  
Urinary Albumin ◽  
Converting Enzyme ◽  
Diabetic Kidney ◽  
Angiotensin Converting Enzyme 2 ◽  
Albumin Excretion ◽  
Akita Mice

Diabetic nephropathy (DN) is a microvascular complication of diabetes that is clinically diagnosed by a progressive increase in albuminuria. Alterations within renin angiotensin system balance contribute to the pathogenesis of diabetic kidney disease. Angiotensin converting enzyme 2 (ACE2), a metallocarboxypetidase, has a renoprotective role due to its ability to form Angiotensin (1-7) [Ang-(1-7)] by degrading Angiotensin II (Ang II). Accumulating evidence shows that strict glycemic control attenuates diabetic kidney damage. Therefore, the aim of this study is to test the hypothesis that normalizing hyperglycemia with insulin will reduce albuminuria by increasing ACE2 in Akita diabetic mice. Type 1 diabetic Akita mice (C57BL/6-Ins2Akita/J) and their wild type (WT) littermates were used. Metabolic parameters were monitored weekly. Urine was collected over 24 hours to measure the urinary albumin, total protein and ACE2 activity. Akita mice developed significant hyperglycemia (Akita: 452±6; WT: 118±2 mg/dL), hypoinsulinemia (Akita: 0.5; WT: 1.5 ng/mL) and hypoadiponectinemia (Akita: 3.0; WT: 6.0 μg/mL) compared to WT mice. There was a significant increase in urinary albumin excretion (Akita: 2.1±0.2; WT: 0.2±0.06 mg/day) in Akita mice compared to WT mice. In addition, Akita mice demonstrated a significant decrease in renal (Akita: 3±0.3; WT: 4.1±0.1 pmol/hr/μg protein) and urinary (Akita: 0.2±0.03; WT: 0.7±0.1 pmol/hr/μg protein) ACE2 activity compared to WT mice (P<0.05). Western blot & immunohistochemistry revealed downregulation of renal ACE2 & nephrin protein expression in Akita mice compared to WT mice. Treatment with insulin implants (LinβitR) for 10 weeks significantly decreased hyperglycemia in Akita mice (treated: 135±21; untreated: 452±6 mg/dL). Insulin treatment significantly decreased urinary albumin excretion (treated: 0.18±0.2; untreated: 2.1±0.2 mg/day) and increased urinary ACE2 activity (treated: 1.3±0.3; untreated: 0.2±0.03 pmol/hr/μg protein) in Akita mice. In conclusion, normalizing hyperglycemia in Akita mice with insulin increased ACE2 activity and attenuated albuminuria.

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