Diabetic renal microvascular disease: the role of hypertension and ACE inhibitors.
1. It has been suggested that hypertension may be an important determinant of the rate of progression of diabetic microangiopathy. 2. Renal microvascular disease as assessed by urinary albumin excretion and glomerular ultrastructure was evaluated in a model in which streptozotocin diabetes was induced in spontaneously hypertensive rats (SHR). 3. Diabetes was associated with increases in urinary albumin excretion, and hypertension resulted in a further increase in albuminuria. 4. Various antihypertensive regimens were administered to diabetic SHR, with the angiotensin-converting enzyme inhibitor perindopril and triple therapy (hydralazine, reserpine and hydrochlorothiazide) being more effective than the calcium antagonist (lacidipine) in retarding the increase in albuminuria in diabetic SHR. 5. Antihypertensive therapy appears to ameliorate the development of diabetic renal disease.
Cooper
M E
ME
Department of Medicine, University of Melbourne, Austin Hospital, Heidelberg, Victoria, Australia.
Rumble
J R
JR
Gin
T
T
Lim-Joon
T
T
D000419:Albuminuria / Q000209:etiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D003921:Diabetes Mellitus, Experimental / Q000150:complications*; D003925:Diabetic Angiopathies / Q000209:etiology* / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000209:etiology; D004095:Dihydropyridines / Q000627:therapeutic use; D006978:Hypertension, Renovascular / Q000150:complications* / Q000188:drug therapy; D007211:Indoles / Q000627:therapeutic use; D007678:Kidney Glomerulus / Q000648:ultrastructure; D008297:Male; D020913:Perindopril; D051381:Rats; D011918:Rats, Inbred SHR; D011921:Rats, Inbred WKY
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D007211:Indoles; C060285:lacidipine; D020913:Perindopril