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Beneficial effect of verapamil added to chronic ACE inhibitor treatment on renal function in hypertensive elderly patients
Authors:Bitar  Reda  Flores  Olga  Reverte  María  López-Novoa  José Miguel  Macías  Juan Florencio
Affiliation:(1) Instituto Reina Sofía de Investigación Nefrológica and Departamento de Fisiología y Farmacología, Universidad de Salamanca, Spain;(2) Departamento de Medicina, Servicio de Nefrología, Hospital Clínico Universitario, Universidad de Salamanca, Paseo de San Vicente s/n, 37007 Salamanca, Spain
Abstract:This study analysed the effect of low doses ofverapamil added to chronic treatment withangiotensin-converting enzyme (ACE) inhibitors onblood pressure and serum creatinine levels in eightelderly hypertensive patients who had a steadyincrease of serum creatinine while on ACE inhibitors.The study was performed in eight elderly hypertensivesubjects, five men and three women (mean age 70 ±2 years; systolic blood pressure 173 ± 4 mmHg; diastolic blood pressure 99 ± 1 mm Hg) andserum creatinine of 1.60 ± 0.27 mg/dl beforetreatment. During an average of 25 weeks, ACEinhibitors significantly reduced both systolic anddiastolic blood pressures, but serum creatinine levelswere increased over basal levels (0,68 ± 0,20 mg/dl, p < 0.05). During an average of 10 weeks,the addition of verapamil did not decrease bloodpressure further, but serum creatinine levels werereduced to baseline. Our study suggests that theaddition of verapamil to ACE inhibitors can reverseACE-induced increase in creatinine levels in elderlyhypertensive patients in whom this side effect isobserved. This revised version was published online in August 2006 with corrections to the Cover Date.
Keywords:Angiotensing-converting enzyme inhibitor  Elderly  Hypertension  Non-dihydropyridine calcium channel blocker  Serum creatinine  Verapamil
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