Key result
Azelnidipine was equally effective as trichlormethiazide in reducing urinary albumin when combined with olmesartan (79.8 vs 89.7 mg/g creatinine at 6 months).
Why the study?
Does azelnidipine reduce urinary albumin compared to trichlormethiazide when combined with olmesartan in hypertensive patients with diabetes and albuminuria?
RCT (n=143)
Randomized
Does azelnidipine reduce urinary albumin compared to trichlormethiazide when combined with olmesartan in hypertensive patients with diabetes and albuminuria?
Azelnidipine is as effective as a thiazide diuretic in reducing urinary albumin when combined with olmesartan in hypertensive patients with diabetes.
Answers are grounded in this paper and cite their sources.
Azelnidipine offers a viable alternative to trichlormethiazide for albuminuria reduction with olmesartan; reinforces CCB-ARB regimens in diabetic hypertension.
BACKGROUND: A thiazide diuretic used in combination with benazepril is superior to amlodipine plus benazepril in reducing albuminuria in hypertensive patients with diabetes. However, calcium channel blockers have diverse characteristics. Thus, we investigated whether combining an angiotensin receptor blocker with either azelnidipine or a thiazide diuretic produced similar reductions in albuminuria in hypertensive diabetic patients for the same levels of blood pressure achieved. METHODS: Hypertensive patients with type 2 diabetes and albuminuria (30-600 mg/g creatinine) under antihypertensive treatment (mean age 67.0±7.6 years) were instructed to stop all antihypertensive treatment and take a combination of olmesartan (20 mg/day) and amlodipine (5 mg/day) for 3 months (run-in period). Then, patients were randomly assigned to receive either olmesartan plus azelnidipine (16 mg/day; n=71) or olmesartan plus trichlormethiazide (1 mg/day; n=72) for an additional 6 months. The primary end point was urinary excretion of albumin at 6 months after randomization. RESULTS: At the time of randomization, urinary albumin was 116.0 and 107.8 mg/g creatinine (geometric mean) in the azelnidipine and diuretic arms, respectively, and was reduced to a similar extent [79.8 (95% confidence interval 66.4-96.0) and 89.7 (74.6-107.7) mg/g creatinine, respectively, after adjustment for baseline values]. Blood pressure did not differ between the two groups throughout the study period. CONCLUSIONS: Azelnidipine is equally effective as a thiazide diuretic in reducing urinary albumin when used in combination with olmesartan.
No takes yet. Share an insight, caveat, or question.
Kojima et al. (2013) conducted an RCT in Hypertension with type 2 diabetes and albuminuria (n=143). Azelnidipine plus olmesartan vs. Trichlormethiazide 1 mg/day + olmesartan 20 mg/day was evaluated on urinary excretion of albumin at 6 months after randomization. Azelnidipine was equally effective as trichlormethiazide in reducing urinary albumin when combined with olmesartan (79.8 vs 89.7 mg/g creatinine at 6 months).
Synapse has enriched 10 related papers. Consider them for comparative context: