Blood
Pressure Meds May Prevent Kidney Disease
ACE inhibitor blood pressure medications can reduce the
risk of kidney disease in diabetes patients with high blood pressure, says
a report in the Journal of the American Society of Nephrology.
 Blood pressure medications known as angiotensin converting
enzyme inhibitors, or ACE inhibitors, help to dilate blood vessels and lower
blood pressure. About 80 percent to 90 percent of people with type 2 diabetes
also have high blood pressure, a major risk factor for kidney disease in persons
with diabetes.
Typically, about 30 percent of persons with diabetes develop
kidney failure, and an even larger percentage of them may be at risk of premature
death from heart failure.
Controlling blood pressure in these patients may be critical
in reducing or preventing the risk of kidney failure or death for these patients,
says Dr. Piero Ruggenenti, of Mario Negri Institute for Pharmacological Research
in Bergamo.
Dr. Ruggenenti’s study included more than 1,200 patients
with type 2 diabetes and high blood pressure.
They were randomly assigned to receive either an ACE inhibitor
medication; another type of blood pressure medication called a calcium channel
blocker; a combination of ACE inhibitor and calcium channel blocker; or a placebo.
The researchers checked the study participants for rates
of microalbuminuria - small amounts of the protein albumin in urine that are
among the first signs of kidney disease.
After an average of three and one-half years, patients with
good blood pressure control had lower rates of microalbuminuria, regardless
of which treatment they received.
Patients who took the combination treatment showed the greatest
decreases in blood pressure and were less likely to need additional medications
to control their blood pressure.
The researchers also found that taking an ACE inhibitor,
either alone or as part of the combination treatment, provided further protection
against kidney disease, even if a patient's blood pressure remained high.
"Treatment with an ACE inhibitor was particularly important
when the blood pressure was poorly controlled - as may happen in most diabetic
patients with hypertension, despite the use of two, three, or even more drugs," says
Dr. Ruggenenti.
"Our results clearly show that an ACE inhibitor should always
be used in patients with high blood pressure and diabetes, even when they have
no evidence of renal [kidney] or cardiovascular disease," he says.
Always consult your physician for more information.
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