PMID- 10082500
OWN - NLM
STAT- MEDLINE
DCOM- 19990413
LR  - 20190722
IS  - 0194-911X (Print)
IS  - 0194-911X (Linking)
VI  - 33
IP  - 3
DP  - 1999 Mar
TI  - ACE inhibitor versus beta-blocker for the treatment of hypertension in renal 
      allograft recipients.
PG  - 862-8
AB  - Angiotensin-converting enzyme (ACE) inhibitors have been shown to slow the 
      progression of chronic renal failure. However, the value of ACE inhibitors for 
      the treatment of hypertension in renal allograft recipients has not been 
      established. ACE inhibitors dilate the efferent glomerular arteriole, an effect 
      that may aggravate the decrease in glomerular filtration rate resulting from 
      cyclosporine-induced vasoconstriction at the afferent glomerular arteriole. 
      Therefore, the goal of this double-blind, randomized study was to compare the 
      antihypertensive and renal effects of the ACE inhibitor quinapril with those of 
      the beta-blocker atenolol in renal allograft recipients in whom hypertension 
      developed 6 to 12 weeks after transplantation. All patients received cyclosporine 
      as an immunosuppressant and had stable graft function (serum creatinine 
      concentration, <220 micromol/L) at entry into the study. Twenty-nine patients who 
      received quinapril (daily dose titrated between 2.5 and 20 mg) and 30 patients 
      who received atenolol (daily dose titrated between 12.5 and 100 mg) completed the 
      24-month study. The two groups did not differ in age, sex ratio, height, and 
      weight before entry into the study. Quinapril decreased diastolic blood pressure 
      from 96+/-1 to 84+/-1 mm Hg (average throughout treatment period), and atenolol 
      decreased diastolic blood pressure from 96+/-1 to 83+/-1 mm Hg. The serum 
      creatinine concentration did not change significantly in either group after 24 
      months (129+/-8 micromol/L at entry and 148+/-19 micromol/L after 24 months in 
      the quinapril group and 131+/-6 micromol/L at entry and 152+/-15 micromol/L after 
      24 months in the atenolol group; P=NS for both groups). After 24 months, the 
      change in urinary albumin excretion from baseline was -10+/-15 mg/d in the 
      quinapril group and 52+/-32 mg/d in the atenolol group (P=0.03). These results 
      show that quinapril and atenolol are effective antihypertensive drugs when used 
      after renal transplantation. Moreover, compared with atenolol, quinapril has no 
      adverse effects on graft function. The relative reduction in albuminuria observed 
      with quinapril as compared with atenolol could indicate a beneficial effect of 
      quinapril on long-term graft function.
FAU - Hausberg, M
AU  - Hausberg M
AD  - Department of Internal Medicine D, University of Munster, D-48129 Munster, 
      Germany. hausber@uni-muenster.de
FAU - Barenbrock, M
AU  - Barenbrock M
FAU - Hohage, H
AU  - Hohage H
FAU - Muller, S
AU  - Muller S
FAU - Heidenreich, S
AU  - Heidenreich S
FAU - Rahn, K H
AU  - Rahn KH
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Hypertension
JT  - Hypertension (Dallas, Tex. : 1979)
JID - 7906255
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoquinolines)
RN  - 0 (Tetrahydroisoquinolines)
RN  - 50VV3VW0TI (Atenolol)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - AYI8EX34EU (Creatinine)
RN  - RJ84Y44811 (Quinapril)
SB  - IM
MH  - Adolescent
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Adult
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Atenolol/*therapeutic use
MH  - Blood Pressure/drug effects
MH  - Creatinine/blood
MH  - Cyclosporine/therapeutic use
MH  - Double-Blind Method
MH  - Female
MH  - Heart Rate/drug effects
MH  - Humans
MH  - Hypertension/*drug therapy/etiology/metabolism
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoquinolines/*therapeutic use
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Proteinuria/urine
MH  - Quinapril
MH  - *Tetrahydroisoquinolines
EDAT- 1999/03/19 00:00
MHDA- 1999/03/19 00:01
CRDT- 1999/03/19 00:00
PHST- 1999/03/19 00:00 [pubmed]
PHST- 1999/03/19 00:01 [medline]
PHST- 1999/03/19 00:00 [entrez]
AID - 10.1161/01.hyp.33.3.862 [doi]
PST - ppublish
SO  - Hypertension. 1999 Mar;33(3):862-8. doi: 10.1161/01.hyp.33.3.862.