Key result
Eplerenone/enalapril combination therapy resulted in more withdrawals for hyperkalemia (14 patients) compared to eplerenone (6) or enalapril (2) alone in diabetic hypertensives.
Why the study?
Does eplerenone, enalapril, or their combination improve proteinuria and blood pressure in type 2 diabetic patients with hypertension and microalbuminuria?
Population
244 type 2 diabetic patients with mild-to-moderate hypertension and microalbuminuria
Comparison
Eplerenone 200 mg once daily or Eplerenone 200… vs Enalapril 40 mg once daily
Design
RCT, randomly assigned, double-blind
Follow-up
24 weeks
Authors
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Raises hyperkalemia withdrawals with eplerenone/enalapril combo versus monotherapy in diabetic hypertension; reinforces caution with dual RAAS blockade.
RCT (n=244)
Double-blind
Randomly assigned
Does eplerenone, enalapril, or their combination improve proteinuria and blood pressure in type 2 diabetic patients with hypertension and microalbuminuria?
Combination therapy with eplerenone and enalapril in diabetic hypertensive patients increases the risk of hyperkalemia and related treatment withdrawals compared to monotherapy.
Murray Epstein (2002) conducted an RCT in Hypertension with type 2 diabetes and microalbuminuria (n=244). Eplerenone, enalapril, and eplerenone/enalapril combination vs. Active comparators was evaluated on Geometric mean reductions in UACR and adjusted mean changes in SBP/DBP. Eplerenone/enalapril combination therapy resulted in more withdrawals for hyperkalemia (14 patients) compared to eplerenone (6) or enalapril (2) alone in diabetic hypertensives.
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