Open AccessJournal Article
Effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes
Hans-Henrik Parving,Hendrik Lehnert,Jens Bröchner-Mortensen,Ramon Gomis,Steen Andersen,Peter Arner +5 more
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In this article, the authors evaluated the renoprotective effect of an angiotensin II receptor antagonist, irbesartan, in hypertensive type 2 diabetic patients with microalbuminuria.Abstract:
INTRODUCTION Microalbuminuria and hypertension are risk factors for the development of diabetic nephropathy. Blockade of the renin-angiotensin system reduces progression to diabetic nephropathy in type 1 diabetic patients, whereas similar data are lacking for hypertensive type 2 diabetic subjects. We evaluated the renoprotective effect of an angiotensin II receptor antagonist, irbesartan, in hypertensive type 2 diabetic patients with microalbuminuria. MATERIAL AND METHODS Five hundred and ninety hypertensive type 2 diabetic patients with microalbuminuria were enrolled in this multinational, randomised, double-blind, placebo-controlled study of irbesartan 150 mg/daily or 300 mg/daily or matching placebo for two years. The primary outcome was time to progression to diabetic nephropathy, defined as a persistent overnight albuminuria > 200 micrograms/min and at least a 30 per cent increase from baseline. RESULTS Baseline characteristics in the three groups were similar. Ten patients (5.2 per cent) receiving irbesartan 300 mg and 19 patients (9.7 per cent) receiving irbesartan 150 mg daily reached the primary end point, as compared to 30 (14.9 per cent) patients on placebo (hazard ratio 0.30 [95 per cent confidence interval 0.14 to 0.61], p < 0.001 and 0.61 [95 per cent confidence interval 0.34 to 1.08] p = 0.08), respectively). The average blood pressure throughout the study was 144/83, 143/83, and 141/81 mmHg in the placebo, irbesartan 150 mg and 300 mg group, respectively (p = 0.004 for systolic blood pressure). Serious adverse events were less frequent in the patients treated with irbesartan (p = 0.02). DISCUSSIONS Irbesartan is renoprotective independently of its blood pressure lowering effect in type 2 diabetic subjects with microalbuminuria. It is safe and well tolerated.read more
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Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy
Barry M. Brenner,Mark E. Cooper,Dick de Zeeuw,William F. Keane,William E. Mitch,Hans-Henrik Parving,Giuseppe Remuzzi,Steven M. Snapinn,Zhonxin Zhang,Shahnaz Shahinfar +9 more
TL;DR: Losartan conferred significant renal benefits in patients with type 2 diabetes and nephropathy, and it was generally well tolerated.
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Journal Article
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TL;DR: Ramipril was beneficial for cardiovascular events and overt nephropathy in people with diabetes and the cardiovascular benefit was greater than that attributable to the decrease in blood pressure.
Journal ArticleDOI
Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial—the Losartan Heart Failure Survival Study ELITE II
Bertram Pitt,Philip A. Poole-Wilson,Robert Segal,Felipe Martinez,Kenneth Dickstein,A. John Camm,Marvin A. Konstam,Günter A.J. Riegger,George Klinger,James D. Neaton,Divakar Sharma,Balasamy Thiyagarajan +11 more
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