[Observational study of blood pressure control and microalbuminuria in type 2 diabetics on irbesartan or irbesartan/HCTZ].
BACKGROUND
Patients with type 2 diabetes and microalbuminuria have an elevated risk of developing diabetic nephropathy or cardiovascular complications. The effectiveness of AT1 blockers, in particular irbesartan, in these patients has been confirmed in controlled clinical studies. AIM, METHOD: An observational study involving 500 general practitioners and 9057 patients was carried out to establish which therapeutic aims can be achieved under realistic day-to-day conditions. Inclusion criteria were type 2 diabetes, hypertension > 140/90 mmHg and current treatment with irbesartan or irbesartan/hydrochlorothiazide (HTCZ). The observational study covered a period of 6 months.


RESULTS
A blood pressure measurement < or = 130/80 mmHgwas considered optimal, and the target blood pressure was defined as < or = 140/90 mmHg. At the time of the baseline examination, the systolic pressure was outside the target in 80% of the patients, and outside the optimal range in 92%. At the second control measurement the respective figures were 37% and 69%. The diastolic blood pressure was outside the target pressure in 43 % (initially) and in 7% (second measurement) of the patients, and outside the optimal range in 77% (initially) and 43% (second measurement). At the start of the study, microalbuminuria was exhibited by 66.5% of the patients and after 6 months in 50.9%.


CONCLUSIONS
The observational study confirmed the good effect of irbesartan and irbesartan/HCTZ, and the benefit of effective medication and intensive standardized care.
Schmieder
R E
RE
Medizinische Klinik IV der Universität Erlangen-Nürnberg. schmieder@rzmail.uni-erlangen.de
Krekler
M
M
D000368:Aged; D000419:Albuminuria / Q000188:drug therapy*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage* / Q000009:adverse effects; D006973:Hypertension / Q000188:drug therapy*; D000077405:Irbesartan; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D000077405:Irbesartan