ACTION OF TRANDOLAPRIL ON BLOOD-GLUCOSE CONTROL AND MICROALBUMINURIA IN HYPERTENSIVE DIABETICS

The aim of this study was to evaluate the action of trandolapril on bl ood glucose control and microalbuminuria in mild to moderate hypertens ive in patients with non-insulin-dependent diabetes. Sixty-seven patie nts, aged between 33 and 79, were enrolled. After a two week placebo r un-in period, treatment with trandolapril as monotherapy was given for 3 months. The dose of trandolapril was adjusted between 1 and 4 mg/da y according to antihypertensive response. Patients were assessed clini cally and by laboratory investigations each month. Two patients were e xcluded from efficacy analysis because of major protocol deviations. M ean DBP fell, under the influence of treatment, from 101 +/- 5 mmHg to 82 +/- 7 mmHg (p < 0.0001) and mean SBP from 171 +/- 9 mmHg tp 147 +/ - 11 mmHg (p < 0.0001). At three months, 54 patients (84 %) had a DBP less-than-or-equal-to 90 mmHg. Microalbuminuria decreased significantl y (p = 0.03) during treatment. Microalbuminuria returned to normal in 11 of the 13 patients in whom the baseline value was above 21 mug/min and increased to above normal in 2 of the 26 patients who had a normal baseline value. Blood glycosylated hemoglobin, fructosamine, glucose and creatinine, and creatinine clearance remained stable. Plasma potas sium rose slightly in 7 patients. Six adverse events were reported (4 coughs, 1 peripheral edema, 1 plantar mal perforans). One patient died from pulmonary embolism. In conclusion, trandolapril is an effective antihypertensive agent in hypertensive diabetics. Trandolapril causes a significant decrease in microalbuminuria and does not interfere with blood glucose control in these patients.