Choosing the right calcium channel blocker for patients with hypertension and proteinuric chronic kidney disease.

IF 2.2 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Current Medical Research and Opinion Pub Date : 2025-07-01 Epub Date: 2025-08-14 DOI:10.1080/03007995.2025.2544594
Paolo Lido, Luca Di Lullo, Marco Infante, Camillo Ricordi, Stefano Rezk, Daniele Romanello, Gabriele D'Urso, Maria Josè Ceravolo, David Della-Morte, Manfredi Tesauro, Annalisa Noce
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Abstract

Arterial hypertension and diabetes mellitus represent major modifiable risk factors for the occurrence of cardiovascular disease, development of chronic kidney disease (CKD) and progression of CKD to end-stage renal disease (ESRD). In view of the rising burden of hypertension, diabetes mellitus and CKD on a global scale, there is currently a great need for drugs that can effectively prevent the onset and reverse or slow down the progression of CKD in diverse patient populations. Over the last decades, a growing body of evidence has demonstrated that calcium channel blockers (CCBs) can exert cardioprotective and nephroprotective actions. In the present narrative review, we aimed to specifically describe the cardiorenal protective effects of dihydropyridine CCBs (particularly lercanidipine and manidipine, based on the available evidence) and non-dihydropyridine CCBs (verapamil and diltiazem). With regard to this research topic, we also reviewed the 2023 European Society of Hypertension (ESH) Guidelines for the management of arterial hypertension [endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)] and the 2023 European Society of Cardiology (ESC) Guidelines for the management of cardiomyopathies. Finally, we proposed practical criteria for prescribing the most appropriate CCB (among dihydropyridine CCBs and non-dihydropyridine CCBs) for patients with hypertension and proteinuric CKD (with or without diabetes) in different clinical settings.

高血压合并蛋白尿慢性肾病患者钙通道阻滞剂的选择。
动脉高血压和糖尿病是心血管疾病的发生、慢性肾脏疾病(CKD)的发展以及CKD向终末期肾脏疾病(ESRD)发展的主要可改变的危险因素。鉴于高血压、糖尿病和CKD的负担在全球范围内不断增加,目前迫切需要能够在不同患者群体中有效预防CKD发病和逆转或减缓CKD进展的药物。在过去的几十年里,越来越多的证据表明钙通道阻滞剂(CCBs)可以发挥心脏保护和肾保护作用。在目前的叙述性综述中,我们的目的是专门描述二氢吡啶类CCBs(特别是莱尔卡尼地平和曼尼地平,基于现有证据)和非二氢吡啶类CCBs(维拉帕米和地尔硫卓)的心肾保护作用。关于这一研究课题,我们还回顾了2023年欧洲高血压学会(ESH)动脉高血压管理指南[由国际高血压学会(ISH)和欧洲肾脏协会(ERA)认可]和2023年欧洲心脏病学会(ESC)心肌病管理指南。最后,我们提出了在不同临床环境下为高血压和蛋白尿CKD患者(伴有或不伴有糖尿病)开具最合适的CCB(在双氢吡啶CCB和非双氢吡啶CCB之间)的实用标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Medical Research and Opinion
Current Medical Research and Opinion 医学-医学:内科
CiteScore
4.40
自引率
4.30%
发文量
247
审稿时长
3-8 weeks
期刊介绍: Current Medical Research and Opinion is a MEDLINE-indexed, peer-reviewed, international journal for the rapid publication of original research on new and existing drugs and therapies, Phase II-IV studies, and post-marketing investigations. Equivalence, safety and efficacy/effectiveness studies are especially encouraged. Preclinical, Phase I, pharmacoeconomic, outcomes and quality of life studies may also be considered if there is clear clinical relevance
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