Abstract
Objective: The aim of the study was to compare the effect of ACE inhibitor (ACEI) and thiazide diuretic (ThD) on renal plasma flow (RPF), renovascular resistance (RVR) in hypertensive (HT) postmenopausal women according hormone replacement therapy (HRT) taking. Methods: 180 postmenopausal women (mean age 53,17+/−2,92 years) were studied.120 (HT) were randomly assigned to receive either ACEI (perindopryl 4 mg) or ThD (hydrochlorothiazide 25 mg) as antihypertensive therapy for 12months. Both groups of HT and normotensive (NO) were divided on to 3 subgroups (20 women each) according to period of HRT with transdermal patch (Estracomb TTS)taking. Two groups were observed for 6 months without HRT, then HRT was started for the next 6 months and next two groups were recived HRT all 12 months and other two groups were without HRT.NO were also studied receiving HRT the same way. RPF was measured as clearance of J-125 hippurate. RVR was calculated from mean arterial blood pressure (MAP) and RPF. Results: RPF differ significantly at baseline between HT and NO postmenopausal women: RPF (ml/min) 422,95 +/− 75,14; 496,6 +/− 44,99 (p < 0,05) respectively, and RVR (U) differ significantly 0,29 +/− 0,07;0,21 +/− 0,02 (p < 0,001). After 6 months ACEI therapy RPF significantly increased 485,5 +/− 60,2 (p < 0,0001) and decreased from baseline, during ThD therapy 343,55 +/− 53,9 (p < 0,001) and RVR decreased significantly on ACE-I 0,22,96 +/− 1,88 and increased on ThD 31,38 +/− 4,02 (p < 0,001). HRT further increased RPF in ACEI group 521,7 +/− 47,64 (p < 0,001 from baseline) and significantly increased from baseline in ThD group 445,9 +/− 67,64 (p < 0,001). RVR in ACE-I group did not change and decreased significantly in ThD group0,24 +/− 0,04 (p < 0,001). Conclusions: 1. The RPF in postmenopausal women is significantly higher than in hypertensives. 2. Thiazide diuretic treatment decreased while ACEI increases RPF in postmenopausal women with hypertension. 3. HRT during thiazide treatment increased RPF and decreased RVR and has an additive effect on RPF in hypertensive women taking ACE inhibitor.
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