86674
document
Hypertension and non-insulin-dependent diabetes . A comparison between an angiotensin-converting enzyme inhibitor and a calcium antagonist . The effects of the angiotensin-converting enzyme lisinopril were compared with those of the calcium antagonist nifedipine in 162 non-insulin-dependent diabetic hypertensive patients for a 24-week period . In 83 and 79 patients , respectively , lisinopril and slow-release nifedipine produced similar reductions in blood pressure ( systolic/diastolic : -16/-13 mmHg supine and -14/-11 mmHg standing after lisinopril ; -15/-12 mmHg supine and -14/-11 mmHg standing nifedipine ) . Fasting and post-prandial plasma glucose , glycosylated haemoglobin and plasma lipids appeared to be unaffected by either agent . Also , 28 % of the patients on lisinopril and 30 % of those on nifedipine presented microalbuminuria . Both drugs induced a reduction in the albumin excretion rate ( AER ) . The geometric mean x : tolerance factor of the reduction in AER among the 23 microalbuminuric patients on lisinopril ( -10.0 x:1.3 micrograms/min ) was greater , though not significantly so , than that observed in the 26 on nifedipine ( -0.9 x 1.2 micrograms/min ) . Moreover , lisinopril appeared to be better tolerated than nifedipine in our study population . Microalbuminuria is an important risk factor for cardiovascular mortality in non-insulin-dependent diabetic patients as well as in the general population . To what extent a reduction in the AER could ameliorate diabetic patients is , at present , unknown . Finally , both lisinopril and nifedipine showed a similar antihypertensive effect in these patients which was not associated with significant differences in plasma glucose , insulin or lipid concentrations . The clinical consequences of the insignificant differences in AER remain unclear .
86675
Intervention_Pharmacological
angiotensin-converting enzyme inhibitor
86676
Intervention_Pharmacological
calcium antagonist .
86677
Intervention_Pharmacological
angiotensin-converting enzyme lisinopril
86678
Intervention_Pharmacological
calcium antagonist nifedipine
86679
Intervention_Pharmacological
lisinopril and slow-release nifedipine
86680
Intervention_Pharmacological
lisinopril
86681
Intervention_Pharmacological
nifedipine
86682
Intervention_Pharmacological
lisinopril
86683
Intervention_Pharmacological
nifedipine
86684
Intervention_Pharmacological
lisinopril
86685
Intervention_Pharmacological
nifedipine
86686
Intervention_Pharmacological
lisinopril
86687
Intervention_Pharmacological
nifedipine
86688
Outcome_Physical
reductions in blood pressure
86689
Outcome_Physical
Fasting and post-prandial plasma glucose
86690
Outcome_Physical
glycosylated haemoglobin
86691
Outcome_Physical
plasma lipids
86692
Outcome_Physical
albumin excretion rate
86693
Outcome_Physical
reduction in AER
86694
Outcome_Other
tolerated
86695
Outcome_Physical
AER
86696
Outcome_Physical
antihypertensive effect
86697
Outcome_Physical
AER
86698
Participant_Condition
Hypertension
86699
Participant_Condition
non-insulin-dependent diabetes
86700
Participant_Sample-size
162
86701
Participant_Condition
non-insulin-dependent diabetic hypertensive
86702
Participant_Condition
non-insulin-dependent diabetic