Aggressive versus Low Dose Inhibition of the Renin-Angiotensin System for the Treatment of Microalbuminuria in Type 2 Diabetic Patients: A Pilot Study. (18th October 2011)

• Record Type: Journal Article
• Authors: Davidson, M. B.; Tareen, N.; Duran, P.; Aguilar, V.; Lee, M. L.
• Other Names: Hishinuma A. Academic Editor.
• Is Part Of: ISRN endocrinology. Volume 2011(2011)
• Publication Date: 2011-10-18
• Subjects: Endocrinology -- Periodicals; Endocrine System Diseases; Endocrinology; Endocrinology; Electronic journals; Periodical; Fulltext; Internet Resources; Periodicals; Periodicals; 616.4
• DOI: 10.5402/2011/696124
• Languages: English
• ISSNs: 2090-4630

Abstract

Abstract : Objective . This study compares low dose versus aggressive inhibition of the renin angiotensin system (RAS) to treat microalbuminuria (MA). Methods . Patients with MA after a run-in period to control BP to <130/80 mm Hg with 10 mg benazepril plus other drugs and HbA1c levels to <8.0% were randomized to either continue 10 mg benazepril (N = 12 ) or to take maximal doses of benazepril plus losartan in monthly stepwise increases to achieve normoalbuminuria (N = 11 ). Because MA is associated with CVD and inflammation, carotid intima medial thickness (CIMT) and endothelial function by peripheral arterial tonometry (PAT) as surrogate indices of atherosclerosis and highly sensitive C-reactive protein (hs-CRP) to assess inflammation were measured every six months. Results . BP, HbA1c levels, albumin : creatinine ratios, CIMT, PAT, and hs-CRP did not differ over a mean of 12 months between the two groups. Conclusions . Aggressive inhibition of the RAS is unnecessary to treat MA.