title: Time course of antiproteinuric effect of aliskiren in arterial hypertension associated with type 2 diabetes and microalbuminuria.
abstract: The aim was to compare the antiproteinuric effect of aliskiren and ramipril in hypertensive patients with type 2 diabetes and microalbuminuria.
  
  
  
  A total of 138 patients were treated with aliskiren 300 mg/day or ramipril 10 mg/day for 12 weeks and checked after 1, 2, 4, 8 and 12 weeks and 2 and 4 weeks after treatment withdrawal.
  
  
  
  Clinic and ambulatory BP, urinary albumin excretion rate (UAER) and plasma aldosterone were measured.
  
  
  
  Both aliskiren and ramipril induced a similar lowering in clinic and ambulatory BP (p < 0.001 vs baseline). However, such a lowering persisted longer after stopping aliskiren than after stopping ramipril regimen. Both treatments reduced UAER, but the decrease in UAER associated with aliskiren was more pronounced, the difference vs ramipril being maximal at week 12 (-42 vs -15%, p < 0.01). Two weeks after stopping therapy, UAER remained below baseline values with aliskiren, but not in the ramipril group. Plasma aldosterone decreased in the aliskiren group, whereas in the ramipril group it decreased until week 8 and thereafter increased toward baseline values.
  
  
  
  Aliskiren has a greater and more prolonged antiproteinuric effect than R; it might partly be related to a higher degree of intrarenal renin-angiotensin-aldosterone system blockade.
authors: University of Pavia, Clinica Medica II, Centro Ipertensione e Fisiopatologia Cardiovascolare, Department of Internal Medicine and Therapeutics, Piazzale Golgi 19, 27100 Pavia, Italy. r.fogari@unipv.it
authors: Roberto
authors: R
authors: Fogari
authors: Amedeo
authors: A
authors: Mugellini
authors: Annalisa
authors: A
authors: Zoppi
authors: Paola
authors: P
authors: Preti
authors: Pamela
authors: P
authors: Maffioli
authors: Tiziano
authors: T
authors: Perrone
authors: Giuseppe
authors: G
authors: Derosa
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis; D000419:Albuminuria / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D000450:Aldosterone / Q000097:blood; D000577:Amides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005650:Fumarates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017257:Ramipril / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016037:Single-Blind Method; D016896:Treatment Outcome; D000092502:Renin Inhibitors
chemical_list: D000418:Albumins; D000450:Aldosterone; D000577:Amides; D000959:Antihypertensive Agents; D015415:Biomarkers; D005650:Fumarates; D017257:Ramipril; D000092502:Renin Inhibitors; C446481:aliskiren