39747
document
Fixed-dose manidipine/delapril versus losartan/hydrochlorothiazide in hypertensive patients with type 2 diabetes and microalbuminuria . INTRODUCTION 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 . METHODS 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 ) . RESULTS 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 . CONCLUSIONS A fixed-dose manidipine/delapril combination represents a useful addition to the treatment options available to control hypertension complicated by diabetes and microalbuminuria .
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Intervention_Pharmacological
manidipine/delapril
39749
Intervention_Pharmacological
losartan/hydrochlorothiazide
39750
Intervention_Pharmacological
fixed-dose manidipine/delapril
39751
Intervention_Pharmacological
losartan/hydrochlorothiazide ( HCTZ )
39752
Intervention_Pharmacological
manidipine/delapril
39753
Intervention_Pharmacological
losartan/HCTZ
39754
Intervention_Pharmacological
manidipine/delapril
39755
Intervention_Pharmacological
manidipine/delapril
39756
Intervention_Pharmacological
losartan/HCTZ
39757
Intervention_Pharmacological
manidipine/delapril
39758
Outcome_Physical
blood pressure
39759
Outcome_Physical
microalbuminuria
39760
Outcome_Physical
Blood pressure
39761
Outcome_Physical
systolic and diastolic blood pressure
39762
Outcome_Physical
microalbuminuria
39763
Outcome_Physical
Glycemia
39764
Outcome_Physical
blood glucose concentration
39765
Outcome_Adverse-effects
adverse events
39766
Participant_Condition
hypertensive
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Participant_Condition
type 2 diabetes
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Participant_Condition
microalbuminuria
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Participant_Condition
diabetes
39770
Participant_Condition
hypertension
39771
Participant_Condition
microalbuminuria
39772
Participant_Condition
type 2 diabetes
39773
Participant_Condition
hypertension
39774
Participant_Condition
microalbuminuria