Arzneimittelforschung 2010; 60(2): 64-70
DOI: 10.1055/s-0031-1296250
Antihypertensives
Editio Cantor Verlag Aulendorf (Germany)

Effects of combination therapy with angiotensin II type I receptor blockers and calcium channel blockers on renal function in hypertensive patients
A retrospective, “real-world” comparative study

Harutaka Yamada
1   Department of Internal Medicine, Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Aichi, Japan
2   Kawana Hospital, Internal medicine, Aichi, Japan
,
Norihiro Suga
1   Department of Internal Medicine, Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Aichi, Japan
,
Kunihiro Maeda
1   Department of Internal Medicine, Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Aichi, Japan
,
Yukihiro Kimura
1   Department of Internal Medicine, Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Aichi, Japan
,
Naoto Miura
1   Department of Internal Medicine, Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Aichi, Japan
,
Arao Futenma
3   Medical Clinic, Aichi Medical University, Aichi, Japan
,
Hirokazu Imai
1   Department of Internal Medicine, Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Aichi, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
09 December 2011 (online)

Abstract

Background:

Combination therapies with angiotensin II type I receptor blockers (ARBs) and calcium channel blockers (CCBs) are frequently administered to hypertensive patients, because these regimens have renoprotective and antihypertensive effects. However, few studies have focused on the renoprotective effects of individual CCBs when combined with ARBs for hypertension.

Methods:

Two hundred eighty-six outpatients prescribed three different CCBs (benidipine [CAS 91599-74-5], amlodipine [CAS 111470-99-6] and controlled release nifedipine (nifedipine CR) [CAS 21829-25-4]) for hypertension in combination with ARBs during a 4-year period were registered in a retrospective comparative study. The factors that influenced the appearance of renal events defined as doubling of serum creatinine were investigated.

Results:

The renal event rate was significantly lower in the benidipine than in the amlodipine (p < 0.05) and nifedipine CR (p < 0.01) groups. Multivariate analysis revealed hazard ratios for renal events to be significantly higher with chronic kidney disease (CKD) and lower with benidipine. Moreover, among patients with CKD, the benidipine group showed a significantly lower renal event rate than the amlodipine (p < 0.05) and nifedipine groups (p < 0.05).

Conclusion:

In hypertensive patients treated with ARB and CCB, benidipine exhibits a better renoprotective effect than other drugs of this class (amlodipine and nifedipine CR).

 
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