Document Detail


Comparative effects of converting enzyme inhibition and conventional therapy in hypertensive non-insulin dependent diabetics with normal renal function.
MedLine Citation:
PMID:  1794215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of long-term reduction in blood pressure by the angiotensin converting enzyme inhibitor captopril, as single therapy or in combination with hydrochlorothiazide (HCTZ), were compared with those of metoprolol and/or hydrochlorothiazide in 91 hypertensive non insulin-dependent diabetics with normal renal function. Following a single-blind placebo run-in period of 4 weeks, treatments were assigned randomly in a double-blind fashion. During the study, weight and glycosylated hemoglobin remained elevated. After 9 months of treatment, blood pressure fell significantly (p less than 0.0001) in all treatment groups, with most patients achieving goal supine diastolic blood pressure of less than or equal to 85 mmHg. Whereas urinary albumin excretion (UAE) did not change in patients given metoprolol and/or HCTZ, captopril monotherapy (p = 0.0021) or captopril given in combination with HCTZ (p = 0.0002) decreased UAE without affecting glomerular filtration rate. These data are in favour of a renal beneficial effect of angiotensin converting enzyme inhibitors distinct from their effects on systemic blood pressure. Further studies are needed to determine whether this effect persists with longer treatment, and whether it would lead to better preservation of kidney function than other antihypertensive agents.
Authors:
Y Lacourcière; A Nadeau; L Poirier; G Tancrède
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical and investigative medicine. Médecine clinique et experimentale     Volume:  14     ISSN:  0147-958X     ISO Abbreviation:  Clin Invest Med     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-04-09     Completed Date:  1992-04-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7804071     Medline TA:  Clin Invest Med     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  652-60     Citation Subset:  IM    
Affiliation:
Hypertension and Diabetes Research Unit, Centre Hospitalier de l'Université Laval, Québec.
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MeSH Terms
Descriptor/Qualifier:
Aged
Albuminuria / urine
Blood Pressure
Captopril / administration & dosage,  therapeutic use*
Diabetes Mellitus, Type 2 / complications*,  physiopathology
Double-Blind Method
Drug Therapy, Combination
Female
Glomerular Filtration Rate
Hemoglobin A, Glycosylated / metabolism
Humans
Hydrochlorothiazide / administration & dosage,  therapeutic use*
Hypertension / complications,  drug therapy*,  physiopathology
Kidney / physiopathology
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated; 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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