Olmesartan medoxomil and azelnidipine therapy in patients with hypertension and chronic kidney disease in Japan

J Nephrol. 2012 Sep-Oct;25(5):699-708. doi: 10.5301/jn.5000043.

Abstract

Background: In the present investigation we extracted data on hypertensive patients with chronic kidney disease (CKD) who were enrolled in 3 studies - 2 studies of the angiotensin receptor blocker (ARB) olmesartan medoxomil (OLM), lasting 12 weeks and 2 years, respectively, and one of the calcium channel blocker (CCB) azelnidipine (AZ) lasting 12 weeks - to assess the effects of OLM and AZ on blood pressure (BP), estimated glomerular filtration rate (eGFR) and proteinuria in hypertensive patients with CKD in the setting of daily clinical practice.

Methods: The 3 studies followed open prospective cohort designs that represented daily clinical practice in Japan. Patients with CKD at baseline were selected. Change of BP, eGFR and proteinuria on OLM therapy or AZ therapy were analyzed.

Results: At 12 weeks, OLM (n=1,317) and AZ (n=952) therapies exhibited similar BP-lowering effects. AZ led to a significantly (p=0.0069) greater increase of eGFR compared with OLM, while OLM tended to improve proteinuria to a greater extent than AZ. Treatment with OLM for 2 years (n=109) significantly improved proteinuria but did not alter eGFR.

Conclusion: This study shows that OLM and AZ reduced BP and proteinuria without decreasing eGFR in Japanese hypertensive patients with CKD in the setting of daily clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiotensin II Type 1 Receptor Blockers / adverse effects
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Asian People
  • Azetidinecarboxylic Acid / adverse effects
  • Azetidinecarboxylic Acid / analogs & derivatives*
  • Azetidinecarboxylic Acid / therapeutic use
  • Blood Pressure / drug effects
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / therapeutic use*
  • Dihydropyridines / adverse effects
  • Dihydropyridines / therapeutic use*
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / ethnology
  • Hypertension / physiopathology
  • Imidazoles / adverse effects
  • Imidazoles / therapeutic use*
  • Japan / epidemiology
  • Kidney / drug effects
  • Kidney / physiopathology
  • Male
  • Middle Aged
  • Olmesartan Medoxomil
  • Prospective Studies
  • Proteinuria / drug therapy
  • Proteinuria / ethnology
  • Registries
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / ethnology
  • Renal Insufficiency, Chronic / physiopathology
  • Tetrazoles / adverse effects
  • Tetrazoles / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Dihydropyridines
  • Imidazoles
  • Tetrazoles
  • Azetidinecarboxylic Acid
  • Olmesartan Medoxomil
  • azelnidipine