Effect of Small-Dose Captopril on Microalbuminuria in Normotensive Type 2 Diabetic Patients.

Accession number;02A0146458
Title;Effect of Small-Dose Captopril on Microalbuminuria in Normotensive Type 2 Diabetic Patients.
Author;KOSUGI E(Toho Univ. School Of Medicine)   MOGAMI K(Toho Univ. School Of Medicine)   KUBOKI K(Toho Univ. School Of Medicine)   KAMEYAMA M(Toho Univ. School Of Medicine)   INOKUCHI T(Toho Univ. School Of Medicine)   
Journal Title;Journal of the Medical Society of Toho University
Journal Code:G0654A
ISSN:0040-8670
VOL.48;NO.6;PAGE.444-450(2001)
Figure&Table&Reference;FIG.2, TBL.2, REF.11
Pub. Country;Japan
Language;English
Abstract;The aim of this study was to examine the short-term effects of small-dose angiotensin-converting enzyme (ACE) inhibitor treatment, which is known not to affect circadian blood pressure profiles, on the progression of urinary albumin excretion (UAE) in normotensive patients with type 2 diabetes mellitus and microalbuminuria. This was an open-labeled randomized case-control study. Twelve normotensive, type 2 diabetic patients with microalbuminuria were randomly allocated to receive a 2-week course of either 6.25 mg captopril two times daily (cases) or no treatment (controls). After a 4-week washout period, the patients were crossed over from one group to the other and the study protocol was repeated. All of the patients underwent laboratory and clinical evaluations before and after each observation period. Blood pressure was measured every 30 minutes over a 24-hour period on the days marking the beginning and the end of each 2-week observation period. After 2 weeks, there were no statistically significant baseline differences in circadian blood pressure, glycemic control, creatinine clearance (Ccr), UAE levels between the captopril-treated and the control period. The UAE in the captopril-treated period was significantly decreased from 146.+-.50.MU.g/min to 77.+-.33.MU.g/min (p<0.001). There was no decrease in the control period. At the end of each observation period, there was a statistically significant decrease in the mean UAE levels in the captopril-treated period compared to the control period (p<0.001). However, there were no significant differences between the mean circadian blood pressures at the beginning and end of each observation period. Our findings suggest that short-term treatment with a small-dose captopril can reduce UAE levels in normotensive, type 2 diabetic patients with microalbuminuria without exerting systemic hypotensive effects. (author abst.)