title: Effects of long-term enalapril treatment on persistent micro-albuminuria in well-controlled hypertensive and normotensive NIDDM patients.
abstract: OBJECTIVE
  To determine whether long-term treatment with an angiotensin-converting enzyme (ACE) inhibitor has a beneficial effect on the urinary microalbumin excretion and renal function in non-insulin-dependent diabetes mellitus (NIDDM) patients, enalapril (5 mg/day) was administered for 48 months.
  
  
  METHODS
  -Fifty-two patients with NIDDM who had persistent microalbuminuria in the range of 20-300 mg/24 h, serum creatinine < 106.1 microM (1.2 mg/dl), supine systolic blood pressure (BP) < 150 mmHg, supine diastolic BP < 90 mmHg, and HbA1c < 10% were divided into four groups. Twenty-six patients with normotension were divided at random into two groups; one group received enalapril (5 mg/day) (NE group), the other did not receive enalapril (NC group). In the same way, 26 other patients who were already well-controlled with nifedipine (30 mg/day) over a long-term period (4-6 years) were divided at random into two groups; one received enalapril (5 mg/day) (HE group), the other did not receive enalapril (HC group).
  
  
  RESULTS
  After 48 months, urinary albumin excretion (UAE) was markedly reduced in group NE from 102.4 x/divided by 1.3 to 55.5 x/divided by 1.3 mg/24 h (P < 0.005), whereas no significant change occurred in group NC. In the well-controlled hypertensive groups, a significant reduction in UAE occurred in group HE (P < 0.05), whereas no significant change occurred in group HC. No changes in creatinine clearance, BP, or blood glucose control were seen during the study.
  
  
  CONCLUSIONS
  Treatment with enalapril for 48 months may have a beneficial effect on the decline of microalbumin excretion in NIDDM patients.
authors.affiliation: Department of Internal Medicine, Chubu-Rosai Hospital, Nagoya, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sano
authors.forename: T
authors.initials: T
authors.lastname: Kawamura
authors.forename: H
authors.initials: H
authors.lastname: Matsumae
authors.forename: H
authors.initials: H
authors.lastname: Sasaki
authors.forename: M
authors.initials: M
authors.lastname: Nakayama
authors.forename: T
authors.initials: T
authors.lastname: Hara
authors.forename: S
authors.initials: S
authors.lastname: Matsuo
authors.forename: N
authors.initials: N
authors.lastname: Hotta
authors.forename: N
authors.initials: N
authors.lastname: Sakamoto
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000419:Albuminuria / Q000188:drug therapy*; D001794:Blood Pressure; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000517:prevention & control; D004656:Enalapril / Q000627:therapeutic use*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D014280:Triglycerides / Q000097:blood; D001613:beta 2-Microglobulin / Q000652:urine
chemical_list: D000118:Acetylglucosaminidase; D002784:Cholesterol; D003404:Creatinine; D004656:Enalapril; D006442:Glycated Hemoglobin; D009543:Nifedipine; D014280:Triglycerides; D001613:beta 2-Microglobulin