Does captopril reduce blood pressure and urinary albumin excretion in outpatients with mild to moderate arterial hypertension, type 2 diabetes mellitus, and persistent macroalbuminuria?
Captopril effectively lowers blood pressure and reduces macroalbuminuria in hypertensive diabetic patients without compromising renal hemodynamics or function.
Nine outpatients with mild to moderate arterial hypertension, type 2 diabetes mellitus and persistent macroalbuminuria were studied. After 1 month of placebo, the patients were treated with 50 mg captopril twice a day for the following 6 months. Blood pressure and urinary albumin excretion were significantly reduced but no relationship was found between these two variables. No changes were detected in the renal plasma flow, glomerular filtration rate, filtration fraction, renal vascular resistance or metabolic pattern. Captopril significantly reduced blood pressure and albuminuria without any change in the renal function. The decrease in albuminuria may be related to the reduction in blood pressure as well as to a direct effect of captopril on glomerular haemodynamics.
Stornello et al. (1989) studied this question.