A022: Effect of verapamil in the regression of renal damage induced by the administration of ACE inhibitors

• Published in: American journal of hypertension Vol. 13; no. S2; p. 119A
• Main Authors: Calvo, C., López, E., Pérez-Leirós, P., Covelo, M., Gude, F., Ayala, D.E., Hermida, R.C.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2000
• Subjects: ACE inhibitors; creatinine; renal damage; Verapamil
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(00)00555-0

Some patients without renovascular disease develop, after ACE inhibitor (ACEI) administration, deterioration of their renal function, that may be reversed after suppression of the drug. This deterioration can also be apparently reverted after administration of calcium channel blockers (CCB). The objective of this study was to evaluate the possible renoprotector effect of a CCB, Verapamil, in hypertensive patients undergoing treatment with ACEI who developed impairment of their renal function. We studied 26 hypertensive patients (12 men), 56.3 years of age and BMI 27.2 kg/m2, using ACEI medication, who developed an increase in serum creatinine (SC) of at least 20% with respect to their last medical control. Exclusion criteria were functional deterioration of renal origin, chronic ingestion of NSAID, hyperpotassemia, acute renal failure by ACEI and antihypertensive treatment with other drugs. After clinical evaluation including determination of blood pressure (BP), heart rate, and renal funtion (SC and SC clearance, 180 mg/day of Verapamil for 12 weeks were added to the ACEI, with clinical and analytical controls done every 4 weeks to determine therapeutic efficacy and safety. Patients were excluded from the study if BP was >140/90 mm Hg and the SC values increased 20% above basal levels. A small increase in the deterioration of renal function was observed in only 5 (19.5%) patients after including Verapamil to the ACEI. Changes in BP and SC for all 26 patients were as follows: (See Table) Pretreatment ACEI ACEI + Verapamil Systolic BP (mm Hg) 163.2 ± 7.8 151.5 ± 7.4* 140.2 ± 5.4* Diastolic BP (mm Hg) 101.9 ± 2.8 97.0 ± 5.4* 88.6 ± 4.6* SC (mg/dl) 0.94 ± 0.13 1.24 ± 0.14* 1.10 ± 0.11* *P < 0.05 from comparison by t-test with data from the previous column. Results from this trial confirm that the association of a CCB with an ACEI is able to revert the renal damage induced by the use of the ACEI in some hypertensive patients.