828 EFFICACY OF LONG ADMINISTRATION OF ANTIHYPERTENSIVE AGENTS TO THE IMPAIRED TOTAL VASCULAR TONE IN ELDERLY HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE

Objective: We reported cardiovascular changes in chronic kidney disease (CKD) with hypertension might cause impaired circadian variation of total vascular tone (TVT). Therefore we investigated the efficacy of long term administration of antihypertensive agents to the impaired TVT in elderly hypertensive patients with CKD (HTCKD). Methods: Forty-three elderly (69.3 ± 4.2 years) HTCKD were admitted before and after administration of the following agents, and divided into two groups. Those HTCKD who were administered both ARB (telmisartan, 40 mg per day) and calcium channel blocker (amlodipine 5 mg per day) (Group 1, 22 cases), and those HTCKD who were administrated with either A or C (Group 2, 21 cases). The value of creatinine clearance of Group 1 and Group 2 were 69.4. ± 9.7 and 71.3 ± 10.6 ml/min/1.73 m2, respectively. A non-invasive ambulatory BP monitor and a non-invasive continuous cardiac output (CO) monitor were simultaneously attached to subjects for a 24 hour period. BP, CO and TVT were measured during this time. TVT was calculated as follows: [mean BP / cardiac index] x 1,332 dyne.sec/cm5. Results: 1. There was no significant differences of TVT at the untreated stage between Group 1 and Group 2. 2. The TVT after administration of the agents was significantly smaller (p < 0.05) in Group 1 than in Group 2. Conclusion: Accelerated TVT in elderly HTCKD might be ameliorated by long term administration of both ARB and C due to improving cardiovascular changes.