Effect of olmesartan on diurnal blood pressure profile, vascular function, oxidative stress, and renal renin-angiotensin system in hypertensives with chronic kidney disease

INTERVENTION: Olmesartan group: To achieve blood pressure control below 130/80 mmHg, start with once‐daily dosing of olmesartan 5‐10 mg, and increase up to 10‐40 mg if effect of olmesartan on the clinical parameters is insufficient. If necessary, a combination therapy by several anti‐hypertensives will be performed to achive casual blood pressure control below 130/80 mmHg. Control group: To achieve blood pressure control below 130/80 mmHg, start with anti‐hypertensives including ACE inhibitor but other than ARBs, and increase dosage of respective anti‐hypertensives if effect of first‐line anti‐hypertensives on the clinical parameters is insufficient. If necessary, a combination therapy by several anti‐hypertensives will be performed to achive casual blood pressure control below 130/80 mmHg. CONDITION: Hypertension with chronic kidney disease PRIMARY OUTCOME: 1) Abdominal circumference; 2) Casual blood pressure, home blood pressure.; 3) Diurnal blood pressure profile by ambulatory blood pressure monitoring.; 4) Glucose metabolism: FPG, IRI, HbA1c.; 5) Renal function: Urinary protein excretion, BUN, urinary creatinine excretion, urinary albumin excretion, eGFR, urinary type IV collagen excretion. ; 6) Lipid metabolism: total cholesterol, LDL cholesterol, tryglyceride, HDL‐choresterol.; 7) Cardiac function: BNP.; 8) Vascular function: ABI/PWV, FMD.; 9) Inflamation and oxidative stress marker: hs‐CRP, adiponectin, plasma apelin, urinary 8‐OHdG.; 10) Markers of intra‐renal renin‐angiotensin system: plasma and urinary angiotensinogen.; 11) Genotype of renin‐angiotensin system: angiotensinogen, renin, AT1 receptor, ATRAP, Nedd4L.; 12) Examination of renal biopsy specimen (glomerular sclerosis, fibrosis, and expression of ATRAP and AT1 receptor mRNA and protein). INCLUSION CRITERIA: 1) Casual Blood pressure >= 130/80. 2) Chronic kidney disease >= stage 1 (>= microalbunuria).