Change in Albuminuria Is Predictive of Cardiovascular Outcome in Normotensive Patients With Type 2 Diabetes and Microalbuminuria  

Oleh:

Zandbergen, Adrienne A.M. ; Vogt, Liffert ; Zeeuw, Dick de ; Lamberts, Steven W.J. ; and Others

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 30 no. 12 (Dec. 2007), page 3119.
Topik: RAS; renin-angiotensin system

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2007.04 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

INTRODUCTION Microalbuminuria is associated with cardiovascular complications and all-cause mortality in patients with diabetes (1–3). Inhibitors of the renin-angiotensin system (RAS) protect renal and cardiac function in these patients, at least partly independent of the associated blood pressure reduction (4–9). Recently, a few studies showed that reduction in albuminuria in hypertensive diabetic patients reduces the risk of subsequent cardiovascular events (10–12). The question remains whether this risk reduction is explained by the reduction of high blood pressure. No data are available for normotensive diabetic patients. Therefore, we investigated whether sustained change in albuminuria independently predicts cardiovascular outcome in patients with type 2 diabetes and microalbuminuria but without hypertension. RESEARCH DESIGN AND METHODS— The present study is a prospective follow-up study of 67 normotensive patients (baseline blood pressure 140/90 mmHg without antihypertensive treatment) with type 2 diabetes and microalbuminuria (urinary albumin excretion 20–200 mg/l), who participated in a previously published, larger, randomized, double-blind, placebo-controlled, multicenter trial investigating the short-term effects of the angiotensin-receptor antagonist losartan on microalbuminuria (7). Exclusion criteria included a history of macrovascular complications and a baseline serum creatinine level >150 µmol/l. After the original 20-week study period, a cohort of 67 patients from that study was prospectively followed during mean ± SEM 4.7 ± 0.1 years. They were recruited on the basis of their address and received . . . INTRODUCTION Microalbuminuria is associated with cardiovascular complications and all-cause mortality in patients with diabetes (1–3). Inhibitors of the renin-angiotensin system (RAS) protect renal and cardiac function in these patients, at least partly independent of the associated blood pressure reduction (4–9). Recently, a few studies showed that reduction in albuminuria in hypertensive diabetic patients reduces the risk of subsequent cardiovascular events (10–12). The question remains whether this risk reduction is explained by the reduction of high blood pressure. No data are available for normotensive diabetic patients. Therefore, we investigated whether sustained change in albuminuria independently predicts cardiovascular outcome in patients with type 2 diabetes and microalbuminuria but without hypertension. RESEARCH DESIGN AND METHODS— The present study is a prospective follow-up study of 67 normotensive patients (baseline blood pressure 140/90 mmHg without antihypertensive treatment) with type 2 diabetes and microalbuminuria (urinary albumin excretion 20–200 mg/l), who participated in a previously published, larger, randomized, double-blind, placebo-controlled, multicenter trial investigating the short-term effects of the angiotensin-receptor antagonist losartan on microalbuminuria (7). Exclusion criteria included a history of macrovascular complications and a baseline serum creatinine level >150 µmol/l. After the original 20-week study period, a cohort of 67 patients from that study was prospectively followed during mean ± SEM 4.7 ± 0.1 years. They were recruited on the basis of their address and received . . .

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