Renal haemodynamic and protective effects of calcium antagonists in hypertension

Détails

ID Serval
serval:BIB_901C61C54A2F
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Renal haemodynamic and protective effects of calcium antagonists in hypertension
Périodique
Journal of Hypertension
Auteur(s)
Zanchi  A., Brunner  H. R., Waeber  B., Burnier  M.
ISSN
0263-6352
Statut éditorial
Publié
Date de publication
12/1995
Peer-reviewed
Oui
Volume
13
Numéro
12 Pt 1
Pages
1363-75
Notes
Journal Article
Review --- Old month value: Dec
Résumé
In recent years, the ability of the various antihypertensive drugs to provide renal protection has been the subject of increased attention. Whether calcium antagonists prevent or reduce the rate of progression of renal damage is still a matter of controversy. This paper reviews the findings of recent animal and human studies on the haemodynamic and renal protective effects of calcium antagonists. These agents preferentially vasodilate afferent arterioles, leading to an increase in renal blood flow and glomerular filtration rate. These effects are more pronounced in hypertensive patients than in normotensive subjects and persist even when renal function is impaired. In animal models of chronic renal failure, calcium antagonists can reduce glomerulosclerosis. However, the mechanisms involved in their renal protective effect appear to be different from those of angiotensin converting enzyme (ACE) inhibitors as they do not reduce intraglomerular pressure. Renal failure caused by vasoconstriction related to radiocontrast agents or cyclosporine can be partly prevented by the administration of a calcium antagonist. Furthermore, in patients with renal artery stenosis, calcium antagonists reduce blood pressure with less renal blood flow impairment than ACE inhibitors. Preliminary clinical studies suggest that verapamil or diltiazem may reduce proteinuria in hypertensive diabetic patients. Whether these compounds can also retard the progression of renal failure in these patients remains to be established with larger trials.
Mots-clé
Animals Blood Pressure Calcium Channel Blockers/*therapeutic use Hemodynamics/drug effects Humans Hypertension/*drug therapy/*physiopathology Proteinuria/urine Reference Values Renal Circulation/*drug effects
Pubmed
Création de la notice
11/02/2008 10:30
Dernière modification de la notice
03/03/2018 19:24
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