What question did this study set out to answer?

To assess the progression of glomerular filtration rate during antihypertensive therapy and compare the renal outcomes of cilazapril versus amlodipine in hypertensive patients with type 2 diabetes.

February 1, 1996Diabetes

Effects of Cilazapril and Amlodipine on Kidney Function in Hypertensive NIDDM Patients

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Why the study?

Does cilazapril compared to amlodipine improve the course of glomerular filtration rate in hypertensive NIDDM patients?

Population

44 hypertensive NIDDM patients attending outpatient clinics in Italy.

Comparison

Cilazapril titrated to a target blood pressure… vs Amlodipine titrated to a target blood pressure…

Design

RCT, Randomly treated with either cilazapril or amlodipine

Follow-up

3 years

Authors

MVMario VelussiCasa di Cura Villa Pini d’Abruzzo EBEnrico BroccoMultiMedica FFFrancesco FrigatoUniversity of Padua

Discussion

Member takes

Implication

Either agent with effective BP control equally preserves GFR in hypertensive type 2 diabetes; confirms renoprotection independent of albuminuria status.

Key Points

To assess the progression of glomerular filtration rate during antihypertensive therapy and compare the renal outcomes of cilazapril versus amlodipine in hypertensive patients with type 2 diabetes.
Randomized trial of 44 hypertensive type 2 diabetes patients (26 normoalbuminuric and 18 microalbuminuric) assigned to cilazapril or amlodipine to achieve blood pressure < 140/85 mmHg.
Glomerular filtration rate (GFR) was determined via plasma clearance of 51Cr-EDTA at baseline and every 6–12 months throughout a 3-year follow-up.
Annual GFR decline in normoalbuminuric patients was 2.03 ± 0.66 ml·min⁻¹·1.73 m⁻² (95% CI 0.92–3.17) with cilazapril versus 2.01 ± 0.71 ml·min⁻¹·1.73 m⁻² (95% CI 0.82–3.11) with amlodipine.
Annual GFR decline in microalbuminuric patients was 2.15 ± 0.69 ml·min⁻¹·1.73 m⁻² (95% CI 0.86–3.89) with cilazapril versus 2.33 ± 0.83 ml·min⁻¹·1.73 m⁻² (95% CI 1.03–3.67) with amlodipine.
GFR reduction was inversely correlated with mean blood pressure reduction (r = -0.80, P < 0.0001), while albumin excretion rate decreased to an equivalent extent in both arms.

Structured PICO

Does cilazapril compared to amlodipine improve the course of glomerular filtration rate in hypertensive NIDDM patients?

Population

44 hypertensive NIDDM (non-insulin-dependent diabetes mellitus) patients (26 normoalbuminuric and 18 microalbuminuric) attending outpatient clinics in Italy.

Intervention

Cilazapril (ACE inhibitor) titrated to a target blood pressure of < 140/85 mmHg.

Comparator

Amlodipine (calcium channel blocker) titrated to a target blood pressure of < 140/85 mmHg.

Outcome

Course of glomerular filtration rate (GFR) measured by plasma clearance of 51Cr-labeled EDTA at baseline and every 6-12 months during a 3-year follow-up.surrogate

Effective blood pressure control with either cilazapril or amlodipine successfully delays the decline of GFR in hypertensive NIDDM patients, regardless of baseline albuminuria.

Cite This Study

Velussi et al. (1996) studied this question.

synapsesocial.com/papers/6a7f5b8af2faa0fecc6f7f9c https://doi.org/10.2337/diab.45.2.216

Topics

Hypertension management

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Implication

Either agent with effective BP control equally preserves GFR in hypertensive type 2 diabetes; confirms renoprotection independent of albuminuria status.

Effects of Cilazapril and Amlodipine on Kidney Function in Hypertensive NIDDM Patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Effects of Cilazapril and Amlodipine on Kidney Function in Hypertensive NIDDM Patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider