Potential Reno-Protective Effects of Telmisartan in Kurd Non-Diabetic Hypertensive Patients in Hawler City

A. I. Muslih

Abstract


Angiotensin II (AII) type I (AT1) receptor blockers are a well known group of drug that indicated principally for the treatment of hypertension as well as for the protection of kidney function in diabetic patients. Telmisartan is a highly selective angiotensin receptor blocker, and the favourable tolerability profile of telmisartan combined with its long elimination half- life ensure the drug provides pronounced reductions in blood pressure (BP) across the entire 24-hour dosage interval. There is relatively very little data and information available to reveal renoprotective activity of telmisartan in nondiabetic low grade albuminuric Kurd hypertensive patients. Our study explores the effect of telmisartan on mean arterial blood pressure and it also sheds more light on its crucial role in lowering albumin: creatinine ratio in Kurd patients. The results of our study demonstrate that telmisartan reduces mean arterial blood pressure significantly, furthermore the study had explained a significant reduction in albuminuria at the second month of treatment which is regarded as a positive sign of renoprotection.


Keywords


ARBs; Albuminuria; Creatinine; Hypertension; Kurd race; Renal protection; Telmisartan

Full Text:

PDF

References


Akbari, A., Knoll, G., Ferguson, D., McCormic, K. B., Davis, A., & Biyani, M. (2009). Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in peritoneal dialysis: Systematic reviewand meta-analysis of randomized controlled trials. Perit. Dial. Int. 29, 554-561.

American Diabetes Association. (2004). Nephropathy in diabetes. Diabetes Care, 27 (Suppl. 1), S79–S83

American Diabetes Association. (2007). Standards of medical care in diabetes. Diabetes Care, 30 (Suppl. 1), S19-S21.

Beri, T. (2009). Review: Renal protection by inhibition of the renin-angiotensin-aldosterone system. Journal of Renin-Angiotensin-Aldosterone System, 10, 1. doi: 10.1177/1470320309102747

Bianchi, S., Bigazzi, R.. & Campese, V. M. (2006). Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease. Kidney Int, 70, 2116-2123.

Brault, J. J., & Terjung, R. L. (2003). Creatine uptake and creatine transporter expression among rat skeletal muscle fiber types. Am J Physiol Cell Physiol, 284, 1481-1489. doi: 10.1152/ajpcell.00484.2002

Burnier, M., & Maillard, M. (2009). The comparative pharmacology of angiotensin II receptor antagonists. Blood Press Suppl, 10, 6-10. doi:10.1093/eurheartj/sup029.

Cianci, R., Martina, P., Borghesi, F., di Donato, D., Polidori, L., Lai, S., ... Barbano, B. (2011). Revascularization versus medical therapy for renal artery stenosis: Antihypertensive drugs and renal outcome. Angiology, 62, 92-99. doi: 10.1177/0003319710371615

Fogari, R., Mugellini, A., Zoppi, A., Preti, P., Destro, M., Lazzari, P., & Derosa, G. (2012). Effect of telmisartan and ramipril on atrial fibrillation recurrence and severity in hypertensive patients with metabolic syndrome and recurrent symptomatic paroxysmal and persistent atrial fibrillation. Journal of Cardiovascular Pharmacology and Therapeutics, 17, 34-43. doi: 10.1177/1074248410395018

Galle, J., Schwedhelm, E., Pinnetti, S., Böger, R. H., & Wanner, C., & on behalf of the VIVALDI investigators (2008). Antiproteinuric effects of angiotensin receptor blockers: telmisartan versus valsartan in hypertensive patients with type 2 diabetes mellitus and overt nephropathy Nephrol. Dial. Transplant. 23, 3174-3183. doi: 10.1093/ndt/gfn230

Guy, M., Borzomato, J. K., Newall, R. G., Kalra, P. A., & Price, C. P. (2009). Protein and albimun-to-creatinine ratios in random urines accurately predict 24 h protein and albumin loss in patients with kidney disease. Ann Clin Biochem, 46, 468-476. doi: 10.1258/acb.2009.009001

Hackam, D. G., Spence, J. D., Garg, A. X., & Textor, S. C. (2007). Role of renin-angiotensin system blockade in atherosclerotic renal artery stenosis and renovascular hypertension. Hypertension, 50, 998-1003. doi: 10.1161/

Hirsch, S. (2008). An update on proteinuric chronic kidney disease: The dual-goal approach. Cleveland Clinic Journal of Medicine, 75, 705-713. doi: 10.3949/ccjm.75.10.705

Hunt, S. A., Abraham, W. T., Chin, M. H., Feldman, A. M., Francis, G. S., Ganiats, T. G., ...Yancy, C. W. (2009). Guidelines for the diagnosis and management of heart failure in adults: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 119, e404-e417.

Iqbal, R., & Shah, S. H. (2011). Diabetic nephropathy. InnovAiT, 4(12), 706-711. doi: 10.1093/innovait/inr081

Kakuta, H., Sudoh, K., Sasmata, M., & Yamagishi, S. (2005). Telmisartan has the strongest binding affinity to angiotensin II type I receptor: Comparison with other angiotensin II type I receptor blockers. Int J Clin Pharmacol Res, 25, 41–46.

Kloth, N., & Lane, A.S. (2011). ACE inhibitor-induced angioedema: A case report and review of current management. Crit Care Resusc, 13(1), 33-7.

Krimholtz, M. J., Karalliedde, J., Thomas, S., Bilous, R., & Viberti, G. (2005). Targeting albumin excretion rate in the treatment of the hypertensive diabetic patient with renal disease. JASN, 16(3), suppl 1 S42-S47.

Lizakowski, S., Rutkowski, P., Tylicki, L., Rutkowski, P., Renke, M., Sulikowska, B., ...Rutkowski, B. (2012). The effect of various types of the renin-angiotensin-aldosteron system blockade on proteinuria in chronic non-diabetic kidney disease: A double-blind cross-over randomised controlled trial. Nephrol. Dial. Transplant, 27(suppl 2), ii96-ii120. doi: 10.1093/ndt/gfs215

Loriga, G., Carru, C., Zinellu, A., Milia, A., & Satta, A. E.(2011). Renin angiotensin system inhibitors (rasi) and intima-media thickness (imt) in early-stage chronic kidney disease (CKD). NDT Plus, 4(suppl 2), 4.s2.30. doi: 10.1093/ndtplus/4.s2.30.

Mancia, G., Schumacher, H., Redon, J., Verdecchia, P., Schmieder, R., Jennings, G., ...Yusuf, S. (2011). Blood pressure targets recommended by guidelines and incidence of cardiovascular and renal events in the ongoing telmisartan alone and in combination with ramipril global endpoint trial (ontarget). Circulation, 124, 1727-1736. doi: 10.1161/CIRCULATIONAHA.110.008870.

Mancia, G., & Corrao, G. (2009). Targeting blood pressure in the management of total cardiovascular risk. European Heart Journal Supplements, 11(Supplement F), F27-F32.

Masson, S., Latini, R., Milani, V., Moretti, L., Rossi, M. G., Carbonieri, E., ...GISSI-HF Investigators. (2010). Prevalence and prognostic value of elevated urinary albumin excretion in patients with chronic heart failure: Data from the gissi-heartfailure trial. Circ Heart Fail, 3, 65-72. doi: 10.1161/CIRCHEARTFAILURE.109.881805

Muslih, A. I. (2012). Reduction of mean arterial pressure and proteinuria by the effect of aceis (lisinopril) in kurdish hypertensive patients in Hawler city. Global Journal of Health Science, 4(5), 1-2.

Ninomiya, T., Perkovic, V., de Galan, B. E., Zoungas, S., Pillai, A., Jardine, M., ...Chalmers, J. (2009). Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol, 20,1813-1821.

Nordquist, L., Brown, R., Fasching, A., Persson, P., & Palm, F. (2009). Proinsulin C-peptide reduces diabetes-induced glomerular hyperfiltration via efferent arteriole dilation and inhibition of tubular sodium reabsorption. Am J Physiol Renal Physiol, 297, F1265-F1272. doi: 10.1152/ajprenal.00228.2009

O’Brien, E. (2008). Ambulatory blood pressure measurement: the case for implementation in primary care. Hypertension, 51, 1435-1441. doi: 10.1161/HYPERTENSIONAHA.107.100008

Özyilmaz, A., Bakker, S. J. L., de Zeeuw, D., de Jong, P. E., Gansevoort, R. T., & PREVEND Study Group. (2010). Selection on albuminuria enhances the efficacy of screening for cardiovascular risk factors. Nephrol. Dial. Transplant, 25, 3560-3568. doi: 10.1093/ndt/gfq478

Powers, B. J., Coeytaux, R. R., Dolor, R. J., Hasselblad, V., Patel, U. D., Yancy, Jr. W. S., ...Sanders, G. D. (2012). Updated report on comparative effectiveness of ace inhibitors, arbs, and direct renin inhibitors for patients with essential hypertension: much more data, little new information. J Gen Intern Med, 27(6), 716-729.

Rahmoni, K., Correia, M. L., Haynes, W. G., & Mark, A. L. (2005). Obesityassociated hypertension: New insights into mechanisms. Hypertension, 45, 9-14.

Rao, R. P., Jain, A. K., & Srinivasan, B. P. (2011). Dual therapy versus monotherapy of trandolapril and telmisartan on diabetic nephropathy in experimentally induced type 2 diabetes mellitus rats. Journal of Renin-Angiotensin-Aldosterone System, 12, 169. doi: 10.1177/1470320310392097

Redding, K. M., Chen, B. L,, Singh, A., Re, R. N., Navar, L. G., Seth, D. M., ...Cook, J. L. (2010). Transgenic mice expressing an intracellular fluorescent fusion ofangiotensin II demonstrate renal thrombotic microangiopathy and elevated blood pressure. Am J Physiol Heart Circ Physiol, 298, 1807-1818. doi: 10.1152/ajpheart.00027.2010

Ruilope, L. M., & Bakris, G. L. (2011). Renal function and target organ damage in hypertension
Eur. Heart J, 32, 1599-1604. doi: 10.1093/eurheartj/ehr003

Russo, L. M., Osicka, T. M., Bonnet, F. Jerums, G., & Comper, W.D. (2002), Albuminuria in hypertension is linked to altered lysosomal activity and TGF-beta1 expression. Hypertension, 39, 281-286.

Sarafidis, P., Tziolas, I., Zebekakis, P., Kanaki, A., itoglou-Makedou, A., Yovos, J., ...Lasaridis, A. (2007). Evaluation of the validity of albumin to creatinine ratio for the determination of low levels of urine albumin excretion in type 2 diabetic hypertensive subjects. Nephrol. Dial. Transplant, 22(suppl 6), 95-96.

Satchell, S.C., & Braet, F. (2009). Glomerular endothelial cell fenestrations: An integral component of the glomerular filtration barrier. Am J Physiol Renal Physiol, 296, 947-956. doi: 10.1152/ajprenal.90601.2008

Savelieva, I., Kakouros, N., Kourliouros, A., & Camm, A. J. (2011). Upstream therapies for management of atrial fibrillation: review of clinical evidence and implications for European Society of Cardiology guidelines. Part I: primary prevention. Europace, 13, 308-328. doi: 10.1093/europace/eur002

Sharpe, M., Jarvis, B., & Goa, K. L. (2001). Telmisartan: A Review of its Use in Hypertension. Drugs, 61(10), 1501-1529.

Shimizu, M., & Kario, K. (2008). Review: Role of the augmentation index in hypertension therapeutic advances in cardiovascular disease. Ther Adv Cardiovasc Dis, 2, 25-35. doi: 10.1177/1753944707086935

Song, J. C., & White, C. M. (2001). Olmisartan medoxomil (CS-866). An angiotensin II receptor blocker for treatment of hypertension. Formulary, 36, 485-500.

Tobe, S. W., Clase, C. M., Gao, P., McQueen, M., Grosshennig, A., Wang, X., ...Mann, J. F. E. (2011). Cardiovascular and renal outcomes with telmisartan, ramipril, or both in people at high renal risk: Results from the ontarget and transcend studies. Circulation, 123, 1098-1107. doi: 10.1161/CIRCULATIONAHA.110.964171

Tuncel, E., Erturk, E., Ersoy, C., Kıyıcı, S., Duran, C., Kuru, N., & Imamoglu, S. (2004). Physical activity alters urinary albumin/creatinine ratio in type 1 diabetic patient. Journal of Sports Science and Medicine, 3, 49-54

Verdecchia, P., Gentile, G., Angeli, F., & Reboldi, G. (2012). Beyond blood pressure: evidence for cardiovascular, cerebrovascular, and renal protective effects of renin–angiotensin system blockers. Therapeutic Advances in Cardiovascular Disease, 6, 81-91. doi: 10.1177/1753944712444866

White, W. B., Lacourciere, Y., Davidai, G. (2004). Effects of the angiotensin II receptor telmisartan versus valsartan on the circadian variation of blood pressure: Impact on the early morning period. Am J Hypertens, 17, 347-353.

Yamagishi, S., Motsui, T., & Nakamura, K. (2008). Telmisartan inhibits advanced glycation end products (AGEs)-elicited endothelial cell injury by suppressing AGE receptor (RAGE) expression via peroxisome proliferator-activated receptor-γ activation. Protein Pept Lett, 15, 850-853.

Yee, M. Mc., Jabbar, S. F., Osunkwo, I., Clement, L., Lane, P. A., Eckman, J. R., & Guasch, A. (2011). Chronic kidney disease and albuminuria in children with sickle cell disease. Clin. J. Am. Soc. Nephrol, 6, 2628-2633.

Zheng, Z., Lin, S., & Shi, H. (2010). A systematic review and meta-analysis of telmisartan vs valsartan in the management of essential hypertension. The Journal Of Clinical Hypertension, 12(6), 414-421. doi: 10.1111/j.1751-7176.2010.00287




DOI: http://dx.doi.org/10.3968/4349

DOI (PDF): http://dx.doi.org/10.3968/g6146

Refbacks

  • There are currently no refbacks.


Copyright (c)



Share us to:   

Reminder

How to do online submission to another Journal?

If you have already registered in Journal A, then how can you submit another article to Journal B? It takes two steps to make it happen:

1. Register yourself in Journal B as an Author

Find the journal you want to submit to in CATEGORIES, click on “VIEW JOURNAL”, “Online Submissions”, “GO TO LOGIN” and “Edit My Profile”. Check “Author” on the “Edit Profile” page, then “Save”.

2. Submission

Go to “User Home”, and click on “Author” under the name of Journal B. You may start a New Submission by clicking on “CLICK HERE”.

We only use the following emails to deal with issues about paper acceptance, payment and submission of electronic versions of our journals to databases:
caooc@hotmail.com; office@cscanada.net; office@cscanada.org
ans@cscanada.net;ans@cscanada.org

 Articles published in Advances in Natural Science are licensed under Creative Commons Attribution 4.0 (CC-BY).

 ADVANCES IN NATURAL SCIENCE Editorial Office

Address: 1055 Rue Lucien-L'Allier, Unit #772, Montreal, QC H3G 3C4, Canada.

Telephone: 1-514-558 6138
Website: Http://www.cscanada.net; Http://www.cscanada.org
E-mail:caooc@hotmail.com; office@cscanada.net

Copyright © 2010 Canadian Research & Development Centre of Sciences and Cultures