A prevenção da hipertensão arterial determina a redução da lesão renal no diabetes experimental

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

The aim of this study was to evaluate the effect of preventing hypertension with drugs that block the renin-angiotensin system or conventional therapy on diabetic nephropathy in a model of genetic hypertension and diabetes. Four-week-old spontaneously hypertensive rats (SHR) streptozotocin-induced diabetes were randomized for no treatment, or for treatment with captopril, losartan or triple therapy (hydrochlorothiazide, reserpine and hydralazine) for 16 weeks. Control SHR received only water. Systolic blood pressure (SBP) increased similarly in control (186 + ou - 3 mmHg, mean + ou - SE) and diabetic SHR (190 + ou - 4) but was reduced to normal range by captopril (128 + ou - 3), losartan (128 + ou - 2) and triple therapy (129 + ou - 2, p<0.0001). Albuminuria was higher in diabetic than in control SHR [geometric mean (variance), 1547 (1076-3018) vs 472 (319-685), p<0.0001]and it was similarly reduced with captopril [499 (404-659)], losartan [622 (470-976)] and triple therapy [479 (362-600), mu g/24h, (p<0.0001)]. Renal fibronectin expression increased in diabetic (125 + ou - 3 densitometric unit, mean + ou - SE) as compared to the controls (51 + ou - 9, p<0.0001)and decreased (p<0.0001 vs diabetic SHR) in captopril (32 + ou - 8), losartan (27 + ou - 4) and triple therapy (35 + ou - 6). Prevention of hypertension in diabetic SHR by captopril, losartan or triple therapy was equally efficacious in reducing albuminuria and expression of renal fibronectin. This results show that tight BP control rather than the class of antihypertensive agent is the main determinant ofattenuation in nephropathy

ASSUNTO(S)

insulina - receptores hipertensão - prevenção inibidores da enzima conversora da angiotensina angiotensina hipertensão enzimas diabetes

ACESSO AO ARTIGO

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