NITRENDIPINE AND ENALAPRIL IN THE TREATMENT OF DIABETIC HYPERTENSIVE PATIENTS WITH MICROALBUMINURIA

A trial to study the efficacy, safety and tolerability of nitrendipine and enalapril in the treatment of diabetic hypertensive patients with microalbuminuria (MA) was performed to compare the effects of both dr ugs in the prevention of the renal impairment. Twenty-eight valid pati ents [13 with nitrendipine (N) and 15 with enalapril (E)] with NIDDM, hypertension (diastolic blood pressure between 90 to 114 mm Hg) and MA (urinary albumin between 30 to 300 mg/24 hr) were recruited in a doub le blind, randomized trial. Following a placebo run-in period of two t o four weeks, all eligible patients were randomly allocated to either N or E treatment. Treatment lasted six months, with two different visi ts at three and six months in which blood pressure (BP), heart rate (H R), renal function and MA were measured. No statistically significant differences on BP and metabolic parameters were found between both tre atment groups. The geometric mean of final glomerular filtration rate (GFR) in the N group was 34.5% higher than in the E group, while the r eduction on MA was most important in the E group. Eleven patients repo rted adverse events (AEs) and there were four dropouts, three of them due to AEs. We conclude that both treatments are a good choice for tre ating diabetic hypertensive patients with early altered renal function , as they reduce BP without altering metabolic parameters, increase GF R and reduce MA with a low frequency of AEs.