Why the study?
Does antihypertensive therapy and intensive glycaemic control reduce microalbuminuria and subsequent cardiovascular and renal morbidity in patients with diabetes mellitus?
Does antihypertensive therapy and intensive glycaemic control reduce microalbuminuria and subsequent cardiovascular and renal morbidity in patients with diabetes mellitus?
Microalbuminuria is a key prognostic marker in diabetes, and while therapies can reduce it, their impact on long-term renal and cardiovascular outcomes requires further evidence.
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Microalbuminuria reduction should not yet alter diabetes management; leaves open whether antihypertensive or glycaemic therapies improve hard renal and cardiovascular outcomes.
Thirty years following the development of the first radioimmunoassay for albumin, microalbuminuria is widely acknowledged as an important predictor of overt nephropathy in patients with Type 1 diabetes and of cardiovascular mortality in Type 2 diabetes. In addition, there is accumulating evidence to suggest that diabetic patients with microalbuminuria may have more advanced retinopathy, higher blood pressure, and worse dyslipidaemia than patients with normal albumin excretion rates. Recent studies have focused on the role of intervention, principally with antihypertensive therapy and intensive glycaemic control, in reducing microalbuminuria. While successful in reducing urinary albumin excretion it remains to be established whether such therapies will be translated into a reduction in renal failure and decreased cardiovascular morbidity and mortality.
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Gilbert et al. (1994) studied this question.
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