Effects of single pill-based combination therapy of amlodipine and atorvastatin on within-visit blood pressure variability and parameters of renal and vascular function in hypertensive patients with chronic kidney disease.
Effects of single pill-based combination therapy of amlodipine and atorvastatin on within-visit blood pressure variability and parameters of renal and vascular function in hypertensive patients with chronic kidney disease.
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DOI：
10.1155/2014/437087
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发表时间：
2014
影响因子：
--
通讯作者：
Umemura S
中科院分区：
文献类型：
--
作者：
Azushima K;Uneda K;Tamura K;Wakui H;Ohsawa M;Kobayashi R;Dejima T;Kanaoka T;Maeda A;Toya Y;Umemura S
严格控制血压（BP）和改善血压谱（如血压变异性）对于抑制高血压和慢性肾脏疾病（CKD）的肾脏恶化和心血管并发症都很重要。在本研究中，我们研究了氨氯地平和阿托伐他汀单丸联合治疗对20例高血压CKD患者目标血压和临床血压谱以及血管和肾脏损害指标的有益影响。氨氯地平和阿托伐他汀联合治疗16周显著降低了临床血压，尽管在基线时没有达到目标，但联合治疗后平均达到了目标血压控制的45%。此外，联合治疗显著降低了访内血压变异性。在对肾损害标志物的影响方面，氨氯地平和阿托伐他汀联合治疗16周可显著降低尿白蛋白（尿白蛋白与肌酐比值，1034±1480 vs 733±1218 mg/g-Cr, P < 0.05），但未降低肾小球滤过率。在血管功能参数方面，联合治疗显著改善了肱-踝脉波速度（baPWV）和中枢收缩压（cSBP） （baPWV, 1903±353 vs 1786±382 cm/s, P < 0.05; cSBP, 148±19 vs 129±23 mmHg, P < 0.01）。总的来说，这些结果表明，氨氯地平和阿托伐他汀联合治疗除了降低高血压合并CKD的血压外，还可能对肾脏和血管损伤以及血压谱产生额外的有益作用。
Both strict blood pressure (BP) control and improvements in BP profile such as BP variability are important for suppression of renal deterioration and cardiovascular complication in hypertension and chronic kidney disease (CKD). In the present study, we examined the beneficial effects of the single pill-based combination therapy of amlodipine and atorvastatin on achievement of the target BP and clinic BP profile, as well as markers of vascular and renal damages in twenty hypertensive CKD patients. The combination therapy with amlodipine and atorvastatin for 16 weeks significantly decreased clinic BP, and achievement of target BP control was attained in an average of 45% after the combination therapy in spite of the presence of no achievement at baseline. In addition, the combination therapy significantly decreased the within-visit BP variability. With respect to the effects on renal damage markers, combination therapy with amlodipine and atorvastatin for 16 weeks significantly decreased albuminuria (urine albumin-to-creatinine ratio, 1034 ± 1480 versus 733 ± 1218 mg/g-Cr, P < 0.05) without decline in estimated glomerular filtration rate. Concerning parameters of vascular function, the combination therapy significantly improved both brachial-ankle pulse wave velocity (baPWV) and central systolic BP (cSBP) (baPWV, 1903 ± 353 versus 1786 ± 382 cm/s, P < 0.05; cSBP, 148 ± 19 versus 129 ± 23 mmHg, P < 0.01). Collectively, these results suggest that the combination therapy with amlodipine and atorvastatin may exert additional beneficial effects on renal and vascular damages as well as BP profile in addition to BP lowering in hypertension with CKD.
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DOI：
10.1136/bmj.f5680
发表时间：
2013-10-03
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Blood Pressure Lowering Treatment Trialists' Collaboration;Ninomiya T;Perkovic V;Turnbull F;Neal B;Barzi F;Cass A;Baigent C;Chalmers J;Li N;Woodward M;MacMahon S
通讯作者：
MacMahon S
影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
4.9
作者：
Kipsa, Jan G.;Schutte, Aletta E.;Segers, Patrick
通讯作者：
Segers, Patrick
影响因子：
4.9
作者：
Ito, Daisuke;Ito, Osamu;Kohzuki, Masahiro
通讯作者：
Kohzuki, Masahiro
影响因子：
3
作者：
Ichihara, Atsuhiro;Kaneshiro, Yuki;Itoh, Hiroshi
通讯作者：
Itoh, Hiroshi