What question did this study set out to answer?

To investigate whether combining half doses of an ACE inhibitor and an angiotensin receptor blocker provides renoprotective effects in type 2 diabetic patients with albuminuria.

January 1, 2005American Journal of HypertensionOpen Access

Combination of half doses of angiotensin type 1 receptor antagonist and angiotensin-converting enzyme inhibitor in diabetic nephropathy

Q: What is the clinical evidence from this study?

Study design: Other. Population: Diabetic nephropathy (n=27). Intervention: Combination of imidapril and candesartan vs. 10 mg imidapril or 8 mg candesartan per day (baseline). Primary outcome: Urinary albumin index (UAI) (p=0.003).

View Full Paper

Ask AI

Bookmark

Key result

Switching to a combination of half-dose imidapril and candesartan significantly reduced the urinary albumin index from 79.4 to 52.5 mg/g Cre (P=0.003) in patients with type 2 diabetes.

Why the study?

Does combination therapy with half doses of ACEi and ARB reduce albuminuria in patients with type 2 diabetes and nephropathy compared to full-dose monotherapy?

Population

27 outpatients with type 2 diabetes mellitus and albuminuria (diabetic kidney disease)

Comparison

Combination of half doses of ACEi and ARB per… vs Prior monotherapy with full dose ACEi or ARB per…

Design

Cohort

Follow-up

3 months

Authors

TFTakao Fujisawa HIH Ikegami MOMasaya Ono

Discussion

Member takes

Overview

Half-dose ACEi/ARB combination may reduce albuminuria independently of BP; leaves open superiority versus full-dose monotherapy in T2D nephropathy.

Key Points

To investigate whether combining half doses of an ACE inhibitor and an angiotensin receptor blocker provides renoprotective effects in type 2 diabetic patients with albuminuria.
Monitored 27 outpatients with type 2 diabetes mellitus with albuminuria who were initially receiving monotherapy of either 10 mg/day imidapril or 8 mg/day candesartan.
Switched participants from monotherapy to combination therapy consisting of 5 mg imidapril and 4 mg candesartan daily for 3 months.
Evaluated changes in urinary albumin index (UAI) and blood pressure from baseline to 3 months using paired t-tests.
Log-transformed urinary albumin index significantly decreased from a baseline of 79.4 (27.4–231) mg/g Cre to 52.5 (17.1–161) mg/g Cre after 3 months (P = 0.003).
Blood pressure measurements showed no statistically significant difference between baseline and the end of combination therapy.
Albuminuria reduction occurred independently of initial blood pressure, baseline urinary albumin index, blood pressure changes, or concurrent antihypertensive medications.

Structured PICO

Does combination therapy with half doses of ACEi and ARB reduce albuminuria in patients with type 2 diabetes and nephropathy compared to full-dose monotherapy?

Population

27 outpatients with type 2 diabetes mellitus and albuminuria, previously on ACEI or ARB monotherapy, followed for 3 months after switching to half-dose combination therapy.

Intervention

Combination of half doses of ACEi (imidapril 5 mg) and ARB (candesartan 4 mg) per day for 3 months

Comparator

Prior monotherapy with full dose ACEi (imidapril 10 mg) or ARB (candesartan 8 mg) per day

Outcome

Urinary albumin index (UAI) and blood pressure (BP)surrogate

Main Result

Absolute Event Rate: 52.5% vs 79.4%

p-value: p=0.003

Cite This Study

Fujisawa et al. (2005) studied Diabetic nephropathy (n=27). Combination of imidapril and candesartan vs. 10 mg imidapril or 8 mg candesartan per day (baseline) was evaluated on Urinary albumin index (UAI) (p=0.003). Switching to a combination of half-dose imidapril and candesartan significantly reduced the urinary albumin index from 79.4 to 52.5 mg/g Cre (P=0.003) in patients with type 2 diabetes.

synapsesocial.com/papers/6a659eb7f3bdf71dcbd69ff8 https://doi.org/10.1016/j.amjhyper.2004.08.001

View Full Paper

Ask AI

Bookmark

January 1, 2005American Journal of HypertensionOpen Access

Combination of half doses of angiotensin type 1 receptor antagonist and angiotensin-converting enzyme inhibitor in diabetic nephropathy

View Full Paper

Ask AI

Bookmark

Key result

Switching to a combination of half-dose imidapril and candesartan significantly reduced the urinary albumin index from 79.4 to 52.5 mg/g Cre (P=0.003) in patients with type 2 diabetes.

Why the study?

Does combination therapy with half doses of ACEi and ARB reduce albuminuria in patients with type 2 diabetes and nephropathy compared to full-dose monotherapy?

Population

27 outpatients with type 2 diabetes mellitus and albuminuria (diabetic kidney disease)

Comparison

Combination of half doses of ACEi and ARB per… vs Prior monotherapy with full dose ACEi or ARB per…

Design

Cohort

Follow-up

3 months

Authors

TFTakao Fujisawa HIH Ikegami MOMasaya Ono

Discussion

Member takes

Overview

Half-dose ACEi/ARB combination may reduce albuminuria independently of BP; leaves open superiority versus full-dose monotherapy in T2D nephropathy.

Key Points

To investigate whether combining half doses of an ACE inhibitor and an angiotensin receptor blocker provides renoprotective effects in type 2 diabetic patients with albuminuria.
Monitored 27 outpatients with type 2 diabetes mellitus with albuminuria who were initially receiving monotherapy of either 10 mg/day imidapril or 8 mg/day candesartan.
Switched participants from monotherapy to combination therapy consisting of 5 mg imidapril and 4 mg candesartan daily for 3 months.
Evaluated changes in urinary albumin index (UAI) and blood pressure from baseline to 3 months using paired t-tests.
Log-transformed urinary albumin index significantly decreased from a baseline of 79.4 (27.4–231) mg/g Cre to 52.5 (17.1–161) mg/g Cre after 3 months (P = 0.003).
Blood pressure measurements showed no statistically significant difference between baseline and the end of combination therapy.
Albuminuria reduction occurred independently of initial blood pressure, baseline urinary albumin index, blood pressure changes, or concurrent antihypertensive medications.

Structured PICO

Does combination therapy with half doses of ACEi and ARB reduce albuminuria in patients with type 2 diabetes and nephropathy compared to full-dose monotherapy?

Population

27 outpatients with type 2 diabetes mellitus and albuminuria, previously on ACEI or ARB monotherapy, followed for 3 months after switching to half-dose combination therapy.

Intervention

Combination of half doses of ACEi (imidapril 5 mg) and ARB (candesartan 4 mg) per day for 3 months

Comparator

Prior monotherapy with full dose ACEi (imidapril 10 mg) or ARB (candesartan 8 mg) per day

Outcome

Urinary albumin index (UAI) and blood pressure (BP)surrogate

Main Result

Absolute Event Rate: 52.5% vs 79.4%

p-value: p=0.003

Cite This Study

synapsesocial.com/papers/6a659eb7f3bdf71dcbd69ff8 https://doi.org/10.1016/j.amjhyper.2004.08.001

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

View Full Paper

Ask AI

Bookmark