Effect of Amlodipine Versus Bisoprolol on Hypertensive Patients With End-stage Renal Disease on Maintenance Hemodialysis.
Status:
Completed
Trial end date:
2021-02-01
Target enrollment:
Participant gender:
Summary
Hypertension is highly prevalent in hemodialysis (HD) patients and leads to increased
morbidity and mortality due to cardiovascular disease(CVD). Left ventricular hypertrophy
(LVH) is both a manifestation of hypertension caused end-organ damage and an independent risk
factor for CVD. Evidence shows that Beta-blockers, especially of low dialyzability decrease
risk of CVD and mortality. Calcium channel blockers (CCBs) were also shown to effectively
control BP in the volume expanded state and reduce cardiovascular disease risk. Asymmetric
dimethyl arginine (ADMA) is a uremic toxin that decreases NO synthesis and is correlated to
LVH, carotid intimal thickness (CIT), CVD, and mortality. Amlodipine is shown in one study to
significantly reduce ADMA level in HD patients. The purpose of this study is to determine the
effect of calcium channel blocker Amlodipine compared to Beta-blocker Bisoprolol on
regression of LVH, reduction of ADMA plasma level and on BP control among hypertensive
patients on HD.