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Journal of Ophthalmology
Volume 2010 (2010), Article ID 106384, 9 pages
http://dx.doi.org/10.1155/2010/106384
Clinical Study

Effect of Trandolapril on Regression of Retinopathy in Hypertensive Patients with Type 2 Diabetes: A Prespecified Analysis of the Benedict Trial

1Clinical Research Center for Rare Diseases ‘Aldo & Cele Daccò’, Mario Negri Institute for Pharmacological Research, Negri Bergamo Laboratories, Via Gavazzeni, 11, 24125 Bergamo, Italy
2Unità di Nefrologia, Azienda Ospedaliera Ospedali Riuniti di Bergamo, 24128 Bergamo, Italy
3Unità di Oftalmologia, Azienda Ospedaliera Ospedali Riuniti di Bergamo, 24128 Bergamo, Italy
4Unità di Diabetologia, Azienda Ospedaliera Ospedali Riuniti di Bergamo, 24128 Bergamo, Italy
5Unità di Diabetologia, Treviglio Hospital, 24047 Bergamo, Italy

Received 19 November 2009; Revised 21 January 2010; Accepted 11 March 2010

Academic Editor: Renu A. Kowluru

Copyright © 2010 Piero Ruggenenti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The effect of angiotensin converting enzyme inhibitors (ACEi) on regression of retinopathy in type 2 diabetics is still ill defined. Methods. We compared the incidence of retinopathy regression in 90 hypertensive type 2 diabetics randomized to at least 3-year blinded ACEi with trandolapril (2 mg/day) or non-ACEi therapy who had preproliferative or proliferative retinopathy at baseline. Results. Over a median (interquartile range) follow-up period of 35.8 (12.4–60.7) months, retinopathy regressed in 27 patients (30.0%). Regression occurred in 18 of 42 patients (42.9%) on ACEi and in 9 of 48 (18.8%) on non-ACEi therapy (adjusted for predefined baseline covariates HR (95% CI): 2.75 (1.18–6.42), 𝑃 = . 0 1 9 3 ). Concomitant treatment with or without Non-Dihydropyridine Calcium Channel Blockers (ndCCBs) did not appreciably affect the incidence of retinopathy regression. Conclusions. Unlike ndCCB, ACEi therapy may have an additional effect to that of intensified BP and metabolic control in promoting regression of diabetic retinopathy.