Renoprotective effects of the combination trandolapril/verapamil in patients with type 2 diabetes mellitus and hypertension

摘要

Objective: To evaluate the effect of the fixed-dose combination of trandolapril/verapamil on albuminuria and renal function in patients with hypertension and type 2 diabetes mellitus unresponsive to treatment with an angiotensin-converting enzyme (ACE) inhibitor. Subjects and methods: 30 patients with type 2 diabetes mellitus and hypertension whose hypertension could not be controlled with at least 6 months' treatment with an ACE inhibitor were treated with a combination of trandolapril/verapamil (2mg/180mg once daily). Patients were evaluated monthly over 6 months for sitting blood pressure (BP), heart rate and plasma glucose. A 24-hour urine albumin and a creatinine clearance examination were done prior to and 6 months after the use of the combination. Results: All the patients had a decrease in their BP, from a mean of 168 ?5/93 ?3mm Hg to 135 ?4/79 ?5mm Hg (p < 0.001), and in urine albumin from 4564.7 ?563 mg/day to 2096.9 ?296 mg/day (p < 0.001). There was no significant change in heart rateor in creatinine clearance. Conclusions: The trandolapril/verapamil combination effectively reduces high BP and albuminuria in patients with type 2 diabetes mellitus whose hypertension is unresponsive to an ACE inhibitor.