Combination Ace Inhibitor/arb

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Introduction

• Randomized, double-blind, cross-over trial

• Study:

• 24 type 1 diabetics with:

• albuminuria > 300 mg/day
• retinopathy

• base-line serum creatinine 1.5 mg/dL ( mean)
• all patients receive 40 mg of enalapril/day
• irbesartan 300 mg/day for 8 weeks vs placebo
• cross-over at 8 weeks ( placebo with irbesartan)

• Results:

• albuminuria reduced 25% during dual blockade
• mean blood pressure lower during dual blockade

• 8 mm Hg systolic, 8 mm Hg diastolic

References

Journal Watch 23(13):107, 2003 Jacobson P et al, Kidney Int 63:1874, 2003 Thurman JM & Schrier RW, Am J Med 114:588, 2003 Rosner MH & Okusa MD, Arch Intern Med 163:1025, 2003

combination of ACE inhibitor/angiotension 2 receptor antagonist