Diabetes with hypertension medical therapy

Revision as of 14:24, 16 September 2011 by Priyamvada Singh (talk | contribs) (/* Study name:LIFE study, 2002{{cite journal| author=Lindholm LH, Ibsen H, Dahlöf B, Devereux RB, Beevers G, de Faire U et al.| title=Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reductio)
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Diabetes mellitus Main page

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Type 1
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Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]

Overview

Hypertension is a common co-morbidity associated with patients of diabetes, especially type 2 diabetes.Co-existence of these conditions strongly predispose patients to both renal as well as cardiovascular (CV) injury. Diabetes is the commonest cause of end-stage renal disease in the United States. The 1994 Working Group Report on Hypertension and Diabetes, has recommended the original blood pressure goals of less than 130/85 mmHg to preserve renal function and reduce cardiovascular events in these groups of patients.

Supportive trial data

Study name:LIFE study, 2002 [1]

  • Study design: Double blinded, randomised, parallel-group trial
  • Sample size: 1195 patients with diabetes, hypertension, left ventricular hypertrophy (on electrocardiograms)
  • Study drugs: Losartan or Atenolol
  • Study period: 4 years
  • Study results: Losartan was found to be more effective than atenolol in reducing composite endpoints like cardiovascular morbidity and all causes mortality in patients with hypertension, diabetes, and left-ventricular hypertrophy.

Study name:Candesartan and Lisinopril microalbuminuria (CALM) study [2]

  • Study design: Double blinded, prospective, randomised, parallel-group trial , multicenteric (4 countries, 37 centers)
  • Sample size: 199 patients with diabetes, hypertension
  • Study drugs: Candesartan or lisinopril
  • Study period: Placebo run in period-4 weeks
    • 12 weeks Candesartan or lisinopril
    • Followed by 12 weeks' monotherapy or combination treatment
  • Study question: Compare the effects of candesartan or lisinopril, or both, on blood pressure and urinary albumin excretion , hypertension, and type 2 diabetes.
  • Study results: Candesartan was found to be as effective as lisinopril in reducing blood pressure and microalbuminuria in hypertensive type 2 diabetics. Combination treatment (Candesartan+lisinopril) is well tolerated and more effective in reducing blood pressure.

Study name:Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial, (FACET), 1998 [3]

References

  1. Lindholm LH, Ibsen H, Dahlöf B, Devereux RB, Beevers G, de Faire U; et al. (2002). "Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol". Lancet. 359 (9311): 1004–10. doi:10.1016/S0140-6736(02)08090-X. PMID 11937179. Review in: ACP J Club. 2002 Nov-Dec;137(3):87
  2. Mogensen CE, Neldam S, Tikkanen I, Oren S, Viskoper R, Watts RW; et al. (2000). "Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study". BMJ. 321 (7274): 1440–4. PMC 27545. PMID 11110735.
  3. Tatti P, Pahor M, Byington RP, Di Mauro P, Guarisco R, Strollo G; et al. (1998). "Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM". Diabetes Care. 21 (4): 597–603. PMID 9571349.

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