Prevention of microalbuminuria in patients with type 2 diabetes and hypertension

Jan Menne, Joseph L. Izzo, Sadayoshi Ito, Andrzej Januszewicz, Shigehiro Katayama, Christos Chatzykirkou, Albert Mimran, Ton J. Rabelink, Eberhard Ritz, Luis M. Ruilope, Lars C. Rump, Giancarlo Viberti, Hermann Haller

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29 Citations (Scopus)

Abstract

Background: We have previously demonstrated in the Randomized Olmesartan and Diabetes Microalbuminuria Prevention study that the angiotensin receptor blocker (ARB) olmesartan delays the onset of microalbuminuria in patients with type 2 diabetes. Now, we investigated the effect in the subpopulation with hypertension. Methods: Overall, 4020 patients with type 2 diabetes and hypertension at baseline (defined by a SBP/DBP ≥130/80 mmHg or use of antihypertensive medication) received either 40 mg olmesartan once daily or placebo for a median of 3.2 years in a randomized, double-blind, multicenter, controlled trial. Additional antihypertensive drugs (except angiotensin- converting enzyme inhibitors or ARBs) were used as needed to lower blood pressure (BP) to less than 130/80 mmHg. Results: The average BP was 126.3/74.7 and 129.5/76.6 mmHg, respectively (P < 0.001). Olmesartan delayed the time to onset of microalbuminuria by 25% (hazard ratio = 0.75; 95% confidence interval = 0.61-0.92, P = 0.007). Patients with a baseline SBP above the median of 136.7 mmHg and a SBP reduction above the median of 17.45 mmHg had a lower incidence of microalbuminuria than patients with a SBP reduction of less than 17.45 (8.1 vs. 11.2%, P < 0.0001). Independent from the baseline BP and the degree of BP reduction a 15-39% increase in the time to onset of microalbuminuria was detectable by olmesartan treatment. Cardiovascular events were comparable and occurred in 93 (4.6%) patients taking olmesartan and 86 (4.4%) taking placebo. Conclusion: Patients with a better BP reduction are less likely to develop microalbuminuria. Treatment with olmesartan delayed the onset of microalbuminuria independent of the baseline BP and the degree of BP reduction.

Original languageEnglish
Pages (from-to)811-818
Number of pages8
JournalJournal of hypertension
Volume30
Issue number4
DOIs
Publication statusPublished - 2012 Apr

Keywords

  • albuminuria
  • angiotensin receptor blocker
  • diabetes
  • diabetic nephropathy
  • hypertension
  • microalbuminuria

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Menne, J., Izzo, J. L., Ito, S., Januszewicz, A., Katayama, S., Chatzykirkou, C., Mimran, A., Rabelink, T. J., Ritz, E., Ruilope, L. M., Rump, L. C., Viberti, G., & Haller, H. (2012). Prevention of microalbuminuria in patients with type 2 diabetes and hypertension. Journal of hypertension, 30(4), 811-818. https://doi.org/10.1097/HJH.0b013e328351856d