肾素-血管紧张素-醛固酮系统抑制剂相关联合用药策略的降压疗效及肾脏保护作用
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摘要
<正>临床实践及病理观察均发现控制不良的高血压会导致慢性肾脏疾病(CKD)或加重既有CKD及糖尿病肾病(DKD)的肾脏损害[1-2]。大型荟萃分析及临床随机对照试验(RCT)结果提示不同降压药对降低心血管事件风险无差异[3]。结合不同降压药适用人群不同,CKD合并高血压没有首选降压药。但蛋
引文
[1]Ritz E,Fliser D,Siebels M.Pathophysiology of hypertensive renal damage[J].Am J Hypertens,1993,6(7 Pt 2):241S-244S.
[2]Peterson JC,Adler S,Burkart JM,et al.Blood pressure control,proteinuria and the progression of renal disease.The Modification of Diet in Renal Disease Study[J].Ann Intern Med,1995,123(10):754-762.
[3]Turnbull F.Effects of different blood-pressure-lowering regimens on major cardiovascular events:results of prospectively-designed overviews of randomised trials[J].Lancet,2003,362(9395):1527-1535.
[4]Taal MW,Brenner BM.Renoprotective benefits of RAS inhibition:from ACEI to angiotensin II antagonists[J].Kidney Int,2000,57(5):1803-1817.
[5]Schmieder RE,Hilgers KF,Schlaich MP,et al.Renin-angiotensin system and cardiovascular risk[J].Lancet,2007,369(9568):1208-1219.
[6]Ruggenenti P,Fassi A,Ilieva A,et al.Effects of verapamil addedon trandolapril therapy in hypertensive type 2 diabetes patients with microalbuminuria:the BENEDICT-B randomized trial[J].JHypertens,2011,29(2):207-216.
[7]Rossing P,Hommel E,Smidt UM,et al.Reduction in albuminuria predicts diminished progression in diabetic nephropathy[J].Kidney Int Suppl,1994,45:S145-149.
[8]Schmitt F,Natov S,Martinez F,et al.Renal effects of angiotensin I-receptor blockade and angiotensin convertase inhibition in man[J]Clin Sci,1996,90(3):205-213.
[9]Wurzner G,Gerster JC,Chiolero A,et al.Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia and gout[J].J Hypertens,2001,19(10):1855-1860.
[10]Dang A,Zhang Y,Liu G,et al.Effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia in Chinese population[J].J Hum Hypertens,2006,20(1):45-50.
[11]Smink PA,Bakker SJ,Laverman GD,et al.An initial reduction in serum uric acid during angiotensin receptor blocker treatment is associated with cardiovascular protection:a post-hoc analysis of the RENAALand IDNT trials[J].J Hypertens,2012,30(5):1022-1028.
[12]Wald DS,Law M,Morris JK,et al.Combination therapy versus monotherapy in reducing blood pressure:meta-analysis on 11,000participants from 42 trials[J].Am J Med,2009,122(3):290-300.
[13]Viberti G,Mogensen CE,Groop LC,et al.Effect of captopril on progression to clinical proteinuria in patients with insulin-dependent diabetes mellitus and microalbuminuria.European Microalbuminuria Captopril Study Group[J].JAMA,1994,271(4):275-279.
[14]Hebert LA,Bain RP,Verme D,et al.Remission of nephrotic range proteinuria in type I diabetes.Collaborative Study Group[J].Kidney Int,1994,46(6):1688-1693.
[15]Liu L,Zhang Y,Liu G,et al.The Felodipine Event Reduction(FEVER)Study:a randomized long-term placebo-controlled trial in Chinese hypertensive patients[J].J Hypertens,2005,23(12):2157-2172.
[16]Nissen SE,Tuzcu EM,Libby P,et al.Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure:the CAMELOT study:a randomized controlled trial[J].JAMA,2004,292(18):2217-2225.
[17]Poole-Wilson PA,Lubsen J,Kirwan BA,et al.Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment(ACTION trial):randomised controlled trial[J].Lancet,2004,364(9437):849-857.
[18]Koh KK,Han SH,Ahn JY,et al.Amlodipine improves endothelial function and metabolic parameters in patients with hypertension[J]Int J Cardiol,2009,133(1):23-31.
[19]Kario K.Proposal of RAS-diuretic vs.RAS-calcium antagonist strategies in high-risk hypertension:insight from the 24-hour ambulatory blood pressure profile and central pressure[J].J Am Soc Hypertens,2010,4(5):215-218.
[20]Nagasu H,Satoh M,Fujimoto S,et al.Azelnidipine attenuates glomerular damage in Dahl salt-sensitive rats by suppressing sympathetic nerve activity[J].Hypertens Res,2012,35(3):348-355.
[21]Dworkin LD.Impact of calcium entry blockers on glomerular injury in experimental hypertension[J].Cardiovasc Drugs Ther,1990,4(5):1325-1330.
[22]Smith AC,Toto R,Bakris GL.Differential effects of calcium channel blockers on size selectivity of proteinuria in diabetic glomerulopathy[J].Kidney Int,1998,54(3):889-896.
[23]R aij L,Keane WF.Glomerular mesangium:its function and relationship to angiotensin II[J].Am J Med,1985,79(3C):24-30.
[24]Sweeney C,Shultz P,Raij L.Interactions of the endothelium and mesangium in glomerular injury[J].J Am Soc Nephrol,1990,1(3Suppl 1):S13-20.
[25]Viberti G,Wheeldon NM.Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus:a blood pressure-independent effect[J].Circulation,2002,106(6):672-678.
[26]Delles C,Klingbeil AU,Schneider MP,et al.Direct comparison of the effects of valsartan and amlodipine on renal hemodynamics in human essential hypertension[J].Am J Hypertens,2003,16(12):1030-1035.
[27]Wenzel RR.Renal protection in hypertensive patients:selection of antihypertensive therapy[J].Drugs,2005,65(Suppl 2):29-39.
[28]Dietz J D,Du S,B ol ten C W,et a l.A number of mar keted dihydropyridine calcium channel blockers have mineralocorticoid receptor antagonist activity[J].Hypertension,2008,51(3):742-748.
[29]Rahman ST,Lauten WB,Khan QA,et al.Effects of eprosartan versus hydrochlorothiazide on markers of vascular oxidation and inflammation and blood pressure(renin-angiotensin system antagonists,oxidation and inflammation)[J].Am J Cardiol,2002,89(6):686-690.
[30]K aplan NM.Effects of antihy per tensive therapy on insulin resistance[J].Hypertension.1992,19(1 Suppl):1116-1118.
[31]Ishimitsu T,Numabe A,Masuda T,et al.Angiotensin-II receptor antagonist combined with calcium channel blocker or diuretic for essential hypertension[J].Hypertens Res,2009,32(11):962-968.
[32]Mancia G,Fagard R,Narkiewicz K,et al.2013 ESH/ESC guidelines for the management of arterial hypertension:the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension(ESH)and of the European Society of Cardiology(ESC)[J].Eur Heart J,2013,34(28):2159-2219.
[33]Schjoedt K J,Rossing K,Juhl TR,et al.Beneficial impact of spironolactone in diabetic nephropathy[J].Kidney Int,2005,68(6):2829-2836.
[34]Pisoni R,Acelajado MC,Cartmill FR,et al.Long-term effects of aldosterone blockade in resistant hypertension associated with chronic kidney disease[J].J Hum Hypertens,2012,26(8):502-506.
[35]Pool JL,Glazer R,Chiang YT,et al.Dose-response efficacy of valsartan a new angiotensin II receptor blocker[J].J Hum Hypertens,1999,13(4):275-281.
[36]Goa KL,Haria M,Wilde MI.Lisinopril.A review of its pharmacology and use in the management of the complications of diabetes mellitus[J].Drugs,1997,53(6):1081-1105.
[37]Mogensen CE,Neldam S,Tikkanen I,et al.Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension,microalbuminuria,and non-insulin dependent diabetes:the candesartan and lisinopril microalbuminuria(CALM)study[J]BMJ,2000,321(7274):1440-1444.
[38]Matos JP,de Lourdes Rodrigues M,Ismerim VL,et al.Effects of dual blockade of the renin angiotensin system in hypertensive type2 diabetic patients with nephropathy[J].Clin Nephrol,2005,64(3):180-189.
[39]Ruilope LM,Aldigier JC,Ponticelli C,et al.Safety of the combination of valsartan and benazepril in patients with chronic renal disease European Group for the Investigation of Valsartan in Chronic Renal Disease[J].J Hypertens,2000,18(1):89-95.
[40]Hansen HP,Rossing P,Tarnow L,et al.Increased glomerular filtration rate after withdrawal of long-term antihypertensive treatment in diabetic nephropathy[J].Kidney Int,1995,47(6):1726-1731.
[41]Hollenberg NK,Fisher ND,Price DA.Pathways for angiotensin II generation in intact human tissue:evidence from comparative pharmacological interruption of the renin system[J].Hypertension1998,32(3):387-392.
[42]Mann JF,Schmieder RE,McQueen M,et al.Renal outcomes with telmisartan,ramipril,or both,in people at high vascular risk(the ONTARGET study):a multicentre,randomised,double-blind controlled trial[J].Lancet,2008,372(9638):547-553.
[43]Imai E,Chan JC,Ito S,et al.Effects of olmesartan on renal and cardiovascular outcomes in type 2 diabetes with overt nephropathy:a multicentre,randomised,placebo-controlled study[J].Diabetologia2011,54(12):2978-2986.
[44]Parving HH,Brenner BM,McMurray JJ,et al.Cardiorenal end points in a trial of aliskiren for type 2 diabetes[J].N Engl J Med,2012367(23):2204-2213.
[45]Boutouyrie P,Bussy C,Hayoz D,et al.Local pulse pressure and regression of arterial wall hypertrophy during long-term antihypertensive treatment[J].Circulation,2000,101(22):2601-2606.
[46]Bakris GL,Fonseca V,Katholi RE,et al.Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension:a randomized controlled trial[J].JAMA,2004,292(18):2227-2236.
[47]Parving HH,Persson F,Lewis JB,et al.Aliskiren combined with losartan in type 2 diabetes and nephropathy[J].N Engl J Med,2008358(23):2433-2446.
[48]Kohan DE,Pollock DM.Endothelin antagonists for diabetic and nondiabetic chronic kidney disease[J].Br J Clin Pharmacol,2013,76(4):573-579.
[48]李俊娟,周靖,李慧英,等.高血压或糖尿病及二者联合作用对新发慢性肾脏病的影响[J].解放军医学杂志,2018,43(10):890-896.
[2]Peterson JC,Adler S,Burkart JM,et al.Blood pressure control,proteinuria and the progression of renal disease.The Modification of Diet in Renal Disease Study[J].Ann Intern Med,1995,123(10):754-762.
[3]Turnbull F.Effects of different blood-pressure-lowering regimens on major cardiovascular events:results of prospectively-designed overviews of randomised trials[J].Lancet,2003,362(9395):1527-1535.
[4]Taal MW,Brenner BM.Renoprotective benefits of RAS inhibition:from ACEI to angiotensin II antagonists[J].Kidney Int,2000,57(5):1803-1817.
[5]Schmieder RE,Hilgers KF,Schlaich MP,et al.Renin-angiotensin system and cardiovascular risk[J].Lancet,2007,369(9568):1208-1219.
[6]Ruggenenti P,Fassi A,Ilieva A,et al.Effects of verapamil addedon trandolapril therapy in hypertensive type 2 diabetes patients with microalbuminuria:the BENEDICT-B randomized trial[J].JHypertens,2011,29(2):207-216.
[7]Rossing P,Hommel E,Smidt UM,et al.Reduction in albuminuria predicts diminished progression in diabetic nephropathy[J].Kidney Int Suppl,1994,45:S145-149.
[8]Schmitt F,Natov S,Martinez F,et al.Renal effects of angiotensin I-receptor blockade and angiotensin convertase inhibition in man[J]Clin Sci,1996,90(3):205-213.
[9]Wurzner G,Gerster JC,Chiolero A,et al.Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia and gout[J].J Hypertens,2001,19(10):1855-1860.
[10]Dang A,Zhang Y,Liu G,et al.Effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia in Chinese population[J].J Hum Hypertens,2006,20(1):45-50.
[11]Smink PA,Bakker SJ,Laverman GD,et al.An initial reduction in serum uric acid during angiotensin receptor blocker treatment is associated with cardiovascular protection:a post-hoc analysis of the RENAALand IDNT trials[J].J Hypertens,2012,30(5):1022-1028.
[12]Wald DS,Law M,Morris JK,et al.Combination therapy versus monotherapy in reducing blood pressure:meta-analysis on 11,000participants from 42 trials[J].Am J Med,2009,122(3):290-300.
[13]Viberti G,Mogensen CE,Groop LC,et al.Effect of captopril on progression to clinical proteinuria in patients with insulin-dependent diabetes mellitus and microalbuminuria.European Microalbuminuria Captopril Study Group[J].JAMA,1994,271(4):275-279.
[14]Hebert LA,Bain RP,Verme D,et al.Remission of nephrotic range proteinuria in type I diabetes.Collaborative Study Group[J].Kidney Int,1994,46(6):1688-1693.
[15]Liu L,Zhang Y,Liu G,et al.The Felodipine Event Reduction(FEVER)Study:a randomized long-term placebo-controlled trial in Chinese hypertensive patients[J].J Hypertens,2005,23(12):2157-2172.
[16]Nissen SE,Tuzcu EM,Libby P,et al.Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure:the CAMELOT study:a randomized controlled trial[J].JAMA,2004,292(18):2217-2225.
[17]Poole-Wilson PA,Lubsen J,Kirwan BA,et al.Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment(ACTION trial):randomised controlled trial[J].Lancet,2004,364(9437):849-857.
[18]Koh KK,Han SH,Ahn JY,et al.Amlodipine improves endothelial function and metabolic parameters in patients with hypertension[J]Int J Cardiol,2009,133(1):23-31.
[19]Kario K.Proposal of RAS-diuretic vs.RAS-calcium antagonist strategies in high-risk hypertension:insight from the 24-hour ambulatory blood pressure profile and central pressure[J].J Am Soc Hypertens,2010,4(5):215-218.
[20]Nagasu H,Satoh M,Fujimoto S,et al.Azelnidipine attenuates glomerular damage in Dahl salt-sensitive rats by suppressing sympathetic nerve activity[J].Hypertens Res,2012,35(3):348-355.
[21]Dworkin LD.Impact of calcium entry blockers on glomerular injury in experimental hypertension[J].Cardiovasc Drugs Ther,1990,4(5):1325-1330.
[22]Smith AC,Toto R,Bakris GL.Differential effects of calcium channel blockers on size selectivity of proteinuria in diabetic glomerulopathy[J].Kidney Int,1998,54(3):889-896.
[23]R aij L,Keane WF.Glomerular mesangium:its function and relationship to angiotensin II[J].Am J Med,1985,79(3C):24-30.
[24]Sweeney C,Shultz P,Raij L.Interactions of the endothelium and mesangium in glomerular injury[J].J Am Soc Nephrol,1990,1(3Suppl 1):S13-20.
[25]Viberti G,Wheeldon NM.Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus:a blood pressure-independent effect[J].Circulation,2002,106(6):672-678.
[26]Delles C,Klingbeil AU,Schneider MP,et al.Direct comparison of the effects of valsartan and amlodipine on renal hemodynamics in human essential hypertension[J].Am J Hypertens,2003,16(12):1030-1035.
[27]Wenzel RR.Renal protection in hypertensive patients:selection of antihypertensive therapy[J].Drugs,2005,65(Suppl 2):29-39.
[28]Dietz J D,Du S,B ol ten C W,et a l.A number of mar keted dihydropyridine calcium channel blockers have mineralocorticoid receptor antagonist activity[J].Hypertension,2008,51(3):742-748.
[29]Rahman ST,Lauten WB,Khan QA,et al.Effects of eprosartan versus hydrochlorothiazide on markers of vascular oxidation and inflammation and blood pressure(renin-angiotensin system antagonists,oxidation and inflammation)[J].Am J Cardiol,2002,89(6):686-690.
[30]K aplan NM.Effects of antihy per tensive therapy on insulin resistance[J].Hypertension.1992,19(1 Suppl):1116-1118.
[31]Ishimitsu T,Numabe A,Masuda T,et al.Angiotensin-II receptor antagonist combined with calcium channel blocker or diuretic for essential hypertension[J].Hypertens Res,2009,32(11):962-968.
[32]Mancia G,Fagard R,Narkiewicz K,et al.2013 ESH/ESC guidelines for the management of arterial hypertension:the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension(ESH)and of the European Society of Cardiology(ESC)[J].Eur Heart J,2013,34(28):2159-2219.
[33]Schjoedt K J,Rossing K,Juhl TR,et al.Beneficial impact of spironolactone in diabetic nephropathy[J].Kidney Int,2005,68(6):2829-2836.
[34]Pisoni R,Acelajado MC,Cartmill FR,et al.Long-term effects of aldosterone blockade in resistant hypertension associated with chronic kidney disease[J].J Hum Hypertens,2012,26(8):502-506.
[35]Pool JL,Glazer R,Chiang YT,et al.Dose-response efficacy of valsartan a new angiotensin II receptor blocker[J].J Hum Hypertens,1999,13(4):275-281.
[36]Goa KL,Haria M,Wilde MI.Lisinopril.A review of its pharmacology and use in the management of the complications of diabetes mellitus[J].Drugs,1997,53(6):1081-1105.
[37]Mogensen CE,Neldam S,Tikkanen I,et al.Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension,microalbuminuria,and non-insulin dependent diabetes:the candesartan and lisinopril microalbuminuria(CALM)study[J]BMJ,2000,321(7274):1440-1444.
[38]Matos JP,de Lourdes Rodrigues M,Ismerim VL,et al.Effects of dual blockade of the renin angiotensin system in hypertensive type2 diabetic patients with nephropathy[J].Clin Nephrol,2005,64(3):180-189.
[39]Ruilope LM,Aldigier JC,Ponticelli C,et al.Safety of the combination of valsartan and benazepril in patients with chronic renal disease European Group for the Investigation of Valsartan in Chronic Renal Disease[J].J Hypertens,2000,18(1):89-95.
[40]Hansen HP,Rossing P,Tarnow L,et al.Increased glomerular filtration rate after withdrawal of long-term antihypertensive treatment in diabetic nephropathy[J].Kidney Int,1995,47(6):1726-1731.
[41]Hollenberg NK,Fisher ND,Price DA.Pathways for angiotensin II generation in intact human tissue:evidence from comparative pharmacological interruption of the renin system[J].Hypertension1998,32(3):387-392.
[42]Mann JF,Schmieder RE,McQueen M,et al.Renal outcomes with telmisartan,ramipril,or both,in people at high vascular risk(the ONTARGET study):a multicentre,randomised,double-blind controlled trial[J].Lancet,2008,372(9638):547-553.
[43]Imai E,Chan JC,Ito S,et al.Effects of olmesartan on renal and cardiovascular outcomes in type 2 diabetes with overt nephropathy:a multicentre,randomised,placebo-controlled study[J].Diabetologia2011,54(12):2978-2986.
[44]Parving HH,Brenner BM,McMurray JJ,et al.Cardiorenal end points in a trial of aliskiren for type 2 diabetes[J].N Engl J Med,2012367(23):2204-2213.
[45]Boutouyrie P,Bussy C,Hayoz D,et al.Local pulse pressure and regression of arterial wall hypertrophy during long-term antihypertensive treatment[J].Circulation,2000,101(22):2601-2606.
[46]Bakris GL,Fonseca V,Katholi RE,et al.Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension:a randomized controlled trial[J].JAMA,2004,292(18):2227-2236.
[47]Parving HH,Persson F,Lewis JB,et al.Aliskiren combined with losartan in type 2 diabetes and nephropathy[J].N Engl J Med,2008358(23):2433-2446.
[48]Kohan DE,Pollock DM.Endothelin antagonists for diabetic and nondiabetic chronic kidney disease[J].Br J Clin Pharmacol,2013,76(4):573-579.
[48]李俊娟,周靖,李慧英,等.高血压或糖尿病及二者联合作用对新发慢性肾脏病的影响[J].解放军医学杂志,2018,43(10):890-896.