title: Effect of captopril or imidapril on the progression of diabetic nephropathy in Japanese with type 1 diabetes mellitus: a randomized controlled study (JAPAN-IDDM).
abstract: OBJECTIVE
  to clarify and confirm the renoprotective effects of ACEIs in Japanese type 1 diabetics.
  
  
  METHODS
  a double-blind randomized study using two ACEIs, imidapril (a prodrug of imdaprilat without an SH-residue) and captopril as well as placebo was performed. Seventy-nine eligible cases were randomized to receive captopril 37.5 mg (n=26), imidapril 5 mg (n=26) or their placebos (n=27) daily in a double-blind manner.
  
  
  RESULTS
  urinary albumin excretion (UAE), determined every half year, was significantly decreased by the ACEIs (placebo vs. ACEIs F=11.316, P=0.001, placebo vs. captopril F=4.260, P=0.043, placebo vs. imidapril F=14.341, P<0.001) during the study period (the mean; 1.48 years). Although the HbA(1C) levels and systolic blood pressure (BP) between the three groups were not different, glycemic and BP control significantly affected UAE. Systolic BP in the placebo group tended to be higher by 7-10 mmHg throughout the study.
  
  
  CONCLUSIONS
  these results suggest that the ACE inhibitors, imidapril and captopril, prevent the increase in UAE in micro and macroalbuminuric patients with type 1 diabetes mellitus and that the target BP might be less than 130/80 mmHg.
authors.affiliation: Fourth Department of Medicine, Saitama Medical School, 38 Morohongo, Moroyamacho, Irumagun, Saitama 350-0495, Japan. skataya@saitama-med.ac.jp
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Katayama
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kikkawa
authors.forename: Syo
authors.initials: S
authors.lastname: Isogai
authors.forename: Nozomu
authors.initials: N
authors.lastname: Sasaki
authors.forename: Nobuo
authors.initials: N
authors.lastname: Matsuura
authors.forename: Naoko
authors.initials: N
authors.lastname: Tajima
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Urakami
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Uchigata
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
mesh_terms: D000328:Adult; D000419:Albuminuria; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002216:Captopril / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D048289:Imidazolidines; D008297:Male; D010919:Placebos
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose; D002216:Captopril; D006442:Glycated Hemoglobin; D007093:Imidazoles; D048289:Imidazolidines; D010919:Placebos; C065166:imidapril