Abstract
Regardless of having a similar antihypertensive effect, different antihypertensive drug classes have a different effect on albuminuria. Patients with albuminuria will usually need more than one drug to achieve blood pressure control, particularly if the aim is also to reduce albuminuria. Albuminuria is independently associated with cardiovascular and renal risk regardless of diabetes status. The recent ESC/ESH guidelines listed microalbuminuria among the hypertension-mediated organ damages. Albumin-to-creatinine ratio was suggested to be included in routine workup for evaluation of every hypertensive patient and changes in albuminuria were considered to have moderate prognostic value. Because of its specific effects on renal hemodynamic and glomerular structure, the ACEIs and ARBs should be prescribed in maximum tolerated doses. The MRAs can be considered in uncontrolled hypertensive patients. The CCBs can be used in addition to the RAAS blockade. Data on antialbuminuric effect of the new CCBs generation (T-type and N-type calcium channel blockers) is promising and they might be preferential CCBs when available. In case of resistant hypertension, thiazide or thiazide-like diuretic has to be added into the combination with RAAS blockers and other antihypertensive drugs. Low-salt intake has to be recommended for all hypertensive patients, particularly those with albuminuria. A multifactorial and early antialbuminuric approach should be started even when albuminuria values are below the cut-off value for microalbuminuria.
Keywords: Arterial hypertension, microalbuminuria, proteinuria, cardiovascular disease, target organ damage, RAAS-inhibition, angiotensin converting enzyme inhibitors, calcium channel blockers, angiotensin ii receptor blockers, Mineralocorticoid receptor antagonist, thiazide-like diuretic.
Current Pharmaceutical Design
Title:Treatment of Hypertension Induced Albuminuria
Volume: 24 Issue: 37
Author(s): Tamara Knežević, Lana Gellineo, Ana Jelaković, Vedran Premužić, Živka Dika, Mario Laganović and Bojan Jelaković*
Affiliation:
- Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Croatia School of Medicine, University of Zagreb, Zagreb,Croatia
Keywords: Arterial hypertension, microalbuminuria, proteinuria, cardiovascular disease, target organ damage, RAAS-inhibition, angiotensin converting enzyme inhibitors, calcium channel blockers, angiotensin ii receptor blockers, Mineralocorticoid receptor antagonist, thiazide-like diuretic.
Abstract: Regardless of having a similar antihypertensive effect, different antihypertensive drug classes have a different effect on albuminuria. Patients with albuminuria will usually need more than one drug to achieve blood pressure control, particularly if the aim is also to reduce albuminuria. Albuminuria is independently associated with cardiovascular and renal risk regardless of diabetes status. The recent ESC/ESH guidelines listed microalbuminuria among the hypertension-mediated organ damages. Albumin-to-creatinine ratio was suggested to be included in routine workup for evaluation of every hypertensive patient and changes in albuminuria were considered to have moderate prognostic value. Because of its specific effects on renal hemodynamic and glomerular structure, the ACEIs and ARBs should be prescribed in maximum tolerated doses. The MRAs can be considered in uncontrolled hypertensive patients. The CCBs can be used in addition to the RAAS blockade. Data on antialbuminuric effect of the new CCBs generation (T-type and N-type calcium channel blockers) is promising and they might be preferential CCBs when available. In case of resistant hypertension, thiazide or thiazide-like diuretic has to be added into the combination with RAAS blockers and other antihypertensive drugs. Low-salt intake has to be recommended for all hypertensive patients, particularly those with albuminuria. A multifactorial and early antialbuminuric approach should be started even when albuminuria values are below the cut-off value for microalbuminuria.
Export Options
About this article
Cite this article as:
Knežević Tamara , Gellineo Lana , Jelaković Ana , Premužić Vedran , Dika Živka , Laganović Mario and Jelaković Bojan *, Treatment of Hypertension Induced Albuminuria, Current Pharmaceutical Design 2018; 24 (37) . https://dx.doi.org/10.2174/1381612825666181126170354
DOI https://dx.doi.org/10.2174/1381612825666181126170354 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Endothelial Dysfunction: The Link Between Homocysteine and Hydrogen Sulfide
Current Medicinal Chemistry Relationship Among Adherence to the Mediterranean Diet and Anthropometric and Metabolic Parameters in Subjects with Obesity
Endocrine, Metabolic & Immune Disorders - Drug Targets Therapeutic Angiogenesis by Gene Therapy for Critical Limb Ischemia: Choice of Biological Agent
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Potential Effect of Anti-Inflammatory Treatment on Reducing the Cardiovascular Risk in Rheumatoid Arthritis
Current Vascular Pharmacology Bariatric Surgery: Indications, Safety and Efficacy
Current Pharmaceutical Design Monoclonal Antibodies in Rare Acquired Thrombotic Disorders: The Paradigms of Paroxysmal Nocturnal Hemoglobinuria, Thrombotic Thrombocytopenic Purpura and Central Retinal Vein Occlusion
Current Vascular Pharmacology Drug-induced Cardiac Mitochondrial Toxicity and Protection: From Doxorubicin to Carvedilol
Current Pharmaceutical Design A Review of the Chemical and Pharmacological Aspects of the Genus Marrubium
Current Pharmaceutical Design Beyond Mitochondria, What Would be the Energy Source of the Cell?
Central Nervous System Agents in Medicinal Chemistry Neurobiology of Sleep Fragmentation: Cortical and Autonomic Markers of Sleep Disorders
Current Pharmaceutical Design Animal Models of Obesity and Metabolic Syndrome: Potential Tools for Alzheimers Disease Research
Current Alzheimer Research A Retrospective Study on Advanced Maternal Age and Assisted Reproductive Techniques, Medico-Legal Advice, “Food for Thought”
Current Pharmaceutical Biotechnology The Osteopontin Tissue Level as a Breast Cancer Biomarker in Females After Mastectomy Measured by the Capillary Gel Electrophoresis Technique
Combinatorial Chemistry & High Throughput Screening Peri-Procedural Care of Renal Nerve Ablation Candidates
Current Clinical Pharmacology Proteomics and Mass Spectrometry: What Have We Learned About The Heart?
Current Cardiology Reviews Classic β-Amyloid Deposits Cluster Around Large Diameter Blood Vessels Rather than Capillaries in Sporadic Alzheimers Disease
Current Neurovascular Research The Emerging Role of Vascular Endothelial Growth Factor (VEGF) in Vascular Homeostasis: Lessons from Recent Trials with Anti-VEGF Drugs
Current Vascular Pharmacology Alterations in the Expression of Amyloid Precursor Protein Cleaving Enzymes mRNA in Alzheimer Peripheral Blood
Current Alzheimer Research Emerging Therapeutic Approaches Multi-Targeting Receptor Tyrosine Kinases and G Protein-Coupled Receptors in Cardiovascular Disease
Cardiovascular & Hematological Agents in Medicinal Chemistry Inhibitors of Nitric Oxide Synthase: What's up and What's Next?
Current Enzyme Inhibition