The Effect Of The Combination Of Benazepril And Candesartan On Hypertension With Microalbuminuria

Background and objectsHypertenive renal damage is one of major cause in hypertenive death. Microalbuminuria has been shown to be the early marker of hypertensive renal disease. Rencent data reveals that microalbuminuria is considered as an independent predictor of cardiovascular morbidity and mortality and is a general marker of endothelial dysfunction. Though increasing evedence documents that effects of combination of ACEI and ARB on diabete renal proteinuria is better than ACEI or ARB alone,data of combination of ACEI and ARB reduecing microalbuminuria in hypertenive nephropathy is very few.We designed this study to compare the different effect between combination of benazepril and candesartan and single therapy of benazepril or candesartan alone on microalbuminuria(MAU) in hypertensive patients.MethodsIn this prospective, randomized study,94 hypertensive patients with microalbuminuria were divided into A or B or C groups.The patients in group A were treated with benazepril,The patients in group C were treated with benazepril and candesartan,The patients in group B were treated with candesartan for at least 8 weeks.The concentration of microalbuminuria (A/C),serum concentration of fasting ET-1,NO,CR,K,and blood pressure (BP) were measured before and after the therapy.ResultThe data shown that systolic and diastolic BPs were decreased significantly after the treatment in 3 groups (P<0.01﹚, but no significant difference was detected among groups ( P>0.05 ) .Concentration of microalbuminuria was decreased significantly after the treatment in 3 groups (P<0.05﹚.This effect was especially obvious in the combination group(P<0.05﹚,compared with another two groups. Serum ET-1 was decreased significantly(P<0.05﹚ and NO was increased significantly (P<0.05﹚after the treatment in 3 groups,respectiveiy.These changes were also obvious in the combination group (P<0.05). Our data shown that there were no significant changes after the treatment among all groups.ConclusionThe combination therapy of benazepril and candesartan is better than that of benazepril or candesartan alone in reducing concentration of microalbuminuria on hypertensive patients with microalbuminuria,which indicates that combination therapy is better than single therapy in the renal protection.AT the same time,we observed more obvious decrese of serum ET-1 and increase of serum NO raising in the combination group,which suggests the renal protection of the combinayion therapy of benazepril and candesartan may be associated with improvement of the endothelial dysfunction.