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Effect of intensive blood pressure control with valsartan on urinary albumin excretion in normotensive patients with type 2 diabetes.
Am J Hypertens 2006; 19(12):1241-8AJ

Abstract

BACKGROUND

Diabetes is the most common cause of renal failure in the United States, and data regarding the effects of aggressive blood pressure (BP) therapy in normotensive patients with type 2 diabetes are inadequate.

METHODS

A total of 129 type 2 diabetic patients with a BP of <140/80 to 90 mm Hg without overt albuminuria were randomized to either intensive BP control (diastolic BP goal 75 mm Hg) using an angiotensin II receptor blocker, valsartan, versus moderate BP control (diastolic BP 80 to 90 mm Hg with placebo initially) to evaluate the effect on the change in urinary albumin excretion (UAE) from baseline.

RESULTS

The mean entrance BP was 126 +/- 8.8/84 +/- 2.4 mm Hg. The mean follow-up period was 1.9 +/- 1.0 years. During the follow-up period, the mean BP was 118 +/- 10.9/75 +/- 5.7 for the intensive v 124 10.9/80 6.5 mm Hg for the moderate BP groups (P < .001). No difference was observed in change in creatinine clearance or serum creatinine from baseline between the two groups. An analysis of covariance model for change in log (UAE + 1), adjusting for age, HBA(1c), duration of diabetes, baseline log (UAE + 1), sex, and ethnicity resulted in a significant treatment difference at 2 years (P = .007) with intensive BP control reducing log (UAE+1) compared with moderate BP control.

CONCLUSION

Intensive BP control with valsartan to <120/80 mm Hg in normotensive patients with type 2 diabetes and normo- or microalbuminuria significantly decreased the progression of UAE and in some cases caused regression of UAE.

Authors+Show Affiliations

University of Colorado Health Sciences Center, Denver, Colorado 80203, USA. ray.estacio@cpcmed.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17161769

Citation

Estacio, Raymond O., et al. "Effect of Intensive Blood Pressure Control With Valsartan On Urinary Albumin Excretion in Normotensive Patients With Type 2 Diabetes." American Journal of Hypertension, vol. 19, no. 12, 2006, pp. 1241-8.
Estacio RO, Coll JR, Tran ZV, et al. Effect of intensive blood pressure control with valsartan on urinary albumin excretion in normotensive patients with type 2 diabetes. Am J Hypertens. 2006;19(12):1241-8.
Estacio, R. O., Coll, J. R., Tran, Z. V., & Schrier, R. W. (2006). Effect of intensive blood pressure control with valsartan on urinary albumin excretion in normotensive patients with type 2 diabetes. American Journal of Hypertension, 19(12), pp. 1241-8.
Estacio RO, et al. Effect of Intensive Blood Pressure Control With Valsartan On Urinary Albumin Excretion in Normotensive Patients With Type 2 Diabetes. Am J Hypertens. 2006;19(12):1241-8. PubMed PMID: 17161769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of intensive blood pressure control with valsartan on urinary albumin excretion in normotensive patients with type 2 diabetes. AU - Estacio,Raymond O, AU - Coll,Joseph R, AU - Tran,Zung Vu, AU - Schrier,Robert W, PY - 2005/11/21/received PY - 2006/05/07/revised PY - 2006/05/11/accepted PY - 2006/12/13/pubmed PY - 2007/2/24/medline PY - 2006/12/13/entrez SP - 1241 EP - 8 JF - American journal of hypertension JO - Am. J. Hypertens. VL - 19 IS - 12 N2 - BACKGROUND: Diabetes is the most common cause of renal failure in the United States, and data regarding the effects of aggressive blood pressure (BP) therapy in normotensive patients with type 2 diabetes are inadequate. METHODS: A total of 129 type 2 diabetic patients with a BP of <140/80 to 90 mm Hg without overt albuminuria were randomized to either intensive BP control (diastolic BP goal 75 mm Hg) using an angiotensin II receptor blocker, valsartan, versus moderate BP control (diastolic BP 80 to 90 mm Hg with placebo initially) to evaluate the effect on the change in urinary albumin excretion (UAE) from baseline. RESULTS: The mean entrance BP was 126 +/- 8.8/84 +/- 2.4 mm Hg. The mean follow-up period was 1.9 +/- 1.0 years. During the follow-up period, the mean BP was 118 +/- 10.9/75 +/- 5.7 for the intensive v 124 10.9/80 6.5 mm Hg for the moderate BP groups (P < .001). No difference was observed in change in creatinine clearance or serum creatinine from baseline between the two groups. An analysis of covariance model for change in log (UAE + 1), adjusting for age, HBA(1c), duration of diabetes, baseline log (UAE + 1), sex, and ethnicity resulted in a significant treatment difference at 2 years (P = .007) with intensive BP control reducing log (UAE+1) compared with moderate BP control. CONCLUSION: Intensive BP control with valsartan to <120/80 mm Hg in normotensive patients with type 2 diabetes and normo- or microalbuminuria significantly decreased the progression of UAE and in some cases caused regression of UAE. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/17161769/Effect_of_intensive_blood_pressure_control_with_valsartan_on_urinary_albumin_excretion_in_normotensive_patients_with_type_2_diabetes_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1016/j.amjhyper.2006.05.011 DB - PRIME DP - Unbound Medicine ER -