Effects of lisinopril and nitrendipine on urinary albumin excretion and renal function in patients with mild to moderate essential hypertension

The present study was designed to evaluate the effects of an ACE inhibitor, lisinopril, and a calcium antagonist, nitrendipine, on urinary albumin exc retion (UAE) and renal function in mild to moderate essential hypertensive patients with microalbuminuria, After the 4-week drug-free period, 17 patie nts were randomly divided into two groups. The first group (group 1: n=8) r eceived lisinopril 10-20 mg daily for 8 weeks followed by nitrendipine 5-10 mg daily for another 8 weeks. The second group (group 2: n=9) received nit rendipine 5-10 mg daily for 8 weeks followed by lisinopril 10-20 mg daily f or another 8 weeks. The mean blood pressure(MBP) significantly decreased in a similar manner in both groups. UAE significantly de creased after 8 week s of treatment with lisinopril in group 1 and after 8 weeks of subsequent t reatment with lisinopril in group 2, On the other hand, UAE was not altered by treatment with nitrendipine. The changes in UAE were significantly corr elated with changes in MBP after 8 weeks of treatment with nitrendipine, bu t not after 8 weeks of treatment with lisinopril, No significant changes in creatinine clearance, urinary excretion of sodium or urinary N-acetyl-beta -D-glucosaminide were observed by any treatment in either group. These res ults suggest that lisinopril, not nitrendipine, reduces UAE in essential hy pertensive patients with microalbuminuria independently of its effective an tihypertensive properties.