Table of Contents
ISRN Endocrinology
Volume 2011, Article ID 696124, 6 pages
http://dx.doi.org/10.5402/2011/696124
Clinical Study

Aggressive versus Low Dose Inhibition of the Renin-Angiotensin System for the Treatment of Microalbuminuria in Type 2 Diabetic Patients: A Pilot Study

Department of Internal Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA

Received 19 July 2011; Accepted 15 August 2011

Academic Editor: A. Hishinuma

Copyright © 2011 M. B. Davidson 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

Objective. This study compares low dose versus aggressive inhibition of the renin angiotensin system (RAS) to treat microalbuminuria (MA). Methods. Patients with MA after a run-in period to control BP to <130/80 mm Hg with 10 mg benazepril plus other drugs and HbA1c levels to <8.0% were randomized to either continue 10 mg benazepril (N=12) or to take maximal doses of benazepril plus losartan in monthly stepwise increases to achieve normoalbuminuria (N=11). Because MA is associated with CVD and inflammation, carotid intima medial thickness (CIMT) and endothelial function by peripheral arterial tonometry (PAT) as surrogate indices of atherosclerosis and highly sensitive C-reactive protein (hs-CRP) to assess inflammation were measured every six months. Results. BP, HbA1c levels, albumin : creatinine ratios, CIMT, PAT, and hs-CRP did not differ over a mean of 12 months between the two groups. Conclusions. Aggressive inhibition of the RAS is unnecessary to treat MA.