COMPARATIVE EFFECTS OF INDAPAMIDE AND CAPTOPRIL ON BLOOD-PRESSURE ANDALBUMIN EXCRETION RATE IN DIABETIC MICROALBUMINURIA

Nephropathy affects about one third of diabetic patients and its onset can be predicted almost a decade in advance by detecting small quanti ties of albumin in the urine (microalbuminuria). Thus, detection of pr oteinuria or microalbuminuria in diabetic patients carries important i mplications and merits intervention, Strategies for delaying the relen tless progression of microalbuminuria to diabetic nephropathy and ulti mately end-stage renal failure are focused on improving glycemic contr ol and reducing blood pressure, Studies with beta-blockers, calcium an tagonists, diuretics, and angiotensin-converting enzyme (ACE) inhibito rs in hypertensive diabetics with microalbuminuria have shown a signif icant reduction in urinary albumin excretion rates (AER), with effecti ve lowering of blood pressure, In a crossover study, we compared the e ffects of captopril versus indapamide as monotherapy for 12 weeks on A ER and blood pressure in 31 diabetic patients with established microal buminuria, The 2 drugs were equally effective in reducing AER (average reduction 30-40%) and had comparable antihypertensive effects.