Document Detail


Captopril or conventional therapy in hypertensive type II diabetics. Three-year analysis.
MedLine Citation:
PMID:  8500859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of long-term treatment with captopril and conventional therapy on albuminuria and metabolic parameters were compared in 74 hypertensive type II diabetics with normal serum creatinine. Patients were treated double-blind with either captopril monotherapy or combined with hydrochlorothiazide or therapy with metoprolol, hydrochlorothiazide, or both for 36 months. The treatment was titrated to achieve goal diastolic blood pressure of < or = 85 mm Hg. The reductions in blood pressures during treatment were similar in patients with (n = 21) and without (n = 53) microalbuminuria treated with either captopril or conventional therapy. No significant changes in albuminuria occurred in normoalbuminuric patients with either therapy. Although albuminuria fell in nearly all patients with microalbuminuria treated with captopril, it rose in eight of 12 patients on conventional therapy, with macroalbuminuria developing in two of them. Renal function was preserved by both types of treatment in both patient groups. Long-term treatment with either conventional therapy or captopril did not alter metabolic variables. We conclude that captopril alone or in combination decreases albuminuria and prevents the development of macroalbuminuria in hypertensive type II diabetics with persistent microalbuminuria. The renoprotective effect of this agent, however, remains to be demonstrated with longer term data on renal function. Aggressive antihypertensive treatment with either captopril or conventional therapy appears to be effective in preventing the onset of microalbuminuria in most normoalbuminuric patients. In contrast, with previous short-term studies, the use of converting enzyme inhibitors or conventional therapy did not cause adverse metabolic effects.
Authors:
Y Lacourcière; A Nadeau; L Poirier; G Tancrède
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hypertension     Volume:  21     ISSN:  0194-911X     ISO Abbreviation:  Hypertension     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-07-01     Completed Date:  1993-07-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  786-94     Citation Subset:  IM    
Affiliation:
Hypertension Research Unit, CHUL Research Center, Centre Hospitalier de l'Université Laval, Ste-Foy, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Albuminuria / urine
Blood Pressure / drug effects
Captopril / therapeutic use*
Diabetes Mellitus, Type 2
Diabetic Angiopathies / drug therapy*,  metabolism,  physiopathology
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Hydrochlorothiazide / therapeutic use
Hypertension / drug therapy*,  metabolism,  physiopathology
Kidney / physiopathology
Male
Metoprolol / therapeutic use
Middle Aged
Prospective Studies
Chemical
Reg. No./Substance:
37350-58-6/Metoprolol; 58-93-5/Hydrochlorothiazide; 62571-86-2/Captopril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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