Fixed-dose manidipine/delapril versus losartan/hydrochlorothiazide in hypertensive patients with type 2 diabetes and microalbuminuria

Fixed-dose manidipine/delapril versus losartan/hydrochlorothiazide in hypertensive patients with type 2 diabetes and microalbuminuria

Author Kohlmann, Osvaldo Autor UNIFESP Google Scholar
Roca-Cusachs, Alejandro Google Scholar
Laurent, Stephane Google Scholar
Schmieder, Roland E. Google Scholar
Wenzel, Rene R. Google Scholar
Fogari, Roberto Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Hosp Santa Creu & Sant Pau
Hop Europeen Georges Pompidou
Univ Hosp
AO Krankenhaus Zell am See
Policlin San Matteo
Abstract Patients with diabetes complicated by hypertension and microalbuminuria have elevated cardiovascular risk, and controlling blood pressure in these patients is an urgent clinical priority. the present study aimed to examine the effects of a fixed-dose combination of antihypertensives on blood pressure and microalbuminuria.Patients with type 2 diabetes, mild-to-moderate hypertension (diastolic blood pressure 85-105 mmHg, systolic blood pressure < 160 mmHg, and 24-hour mean systolic blood pressure > 130 mmHg), and microalbuminuria were randomized to 1 year of doubleblind treatment with fixed-dose manidipine/delapril (n=54) or losartan/hydrochlorothiazide (HCTZ) (n=56).Blood pressure was significantly reduced at 1 year in both groups (-22.2/-14.6 mmHg and -19.5/-14.3 mmHg, for systolic and diastolic blood pressure respectively, P < 0.001 for each), with no significant between-group difference. Reductions in microalbuminuria occurred in both groups, with mean changes at 1 year of -3.9 mg/mmol creatinine (95% CI -5.3, -2.5) for manidipine/delapril (P < 0.001 vs. baseline) and -2.7 mg/mmol creatinine (95% CI -4.0, -1.3) for losartan/HCTZ (P < 0.001 vs. baseline and P=0.199 between groups). Glycemia over the 1-year study was largely unaffected; the blood glucose concentration was reduced from baseline with manidipine/delapril, although not statistically significant (mean change -0.2 mmol/L, P=0.064). Both treatments were well tolerated, with discontinuation for adverse events for one (1.9%) patient in the manidipine/delapril group and two (3.6%) in the losartan/HCTZ group.A fixed-dose manidipine/delapril combination represents a useful addition to the treatment options available to control hypertension complicated by diabetes and microalbuminuria.
Keywords antihypertensive drugs
delapril
fixed-dose combinations
hydrochlorothiazide
hypertension
losartan
manidipine
microalbuminuria
type 2 diabetes
Language English
Date 2009-03-01
Published in Advances in Therapy. New York: Springer, v. 26, n. 3, p. 313-324, 2009.
ISSN 0741-238X (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 313-324
Origin http://dx.doi.org/10.1007/s12325-009-0015-8
Access rights Closed access
Type Article
Web of Science ID WOS:000265144300006
URI http://repositorio.unifesp.br/handle/11600/31354

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