title: Effect of imidapril versus ramipril on urinary albumin excretion in hypertensive patients with type 2 diabetes and microalbuminuria.
abstract: OBJECTIVE
  Aim of this study was to compare the antiproteinuric effect of imidapril (I) and ramipril (R) in diabetic hypertensive patients with microalbuminuria.
  
  
  METHODS
  One hundred and seventy-six patients were randomised to I 10 - 20 mg once daily (od) (n = 88) or R 5 - 10 mg od (n = 88) for 24 weeks. Clinic, ambulatory, central blood pressure (BP), urinary albumin excretion (UAE), plasma Angiotensin II (Ang II), bradykinin and brain natriuretic peptide (BNP) were assessed at baseline and after 6, 12 and 24 weeks.
  
  
  RESULTS
  Both I and R produced a similar decrease in clinic, ambulatory and central BP (p < 0.001 vs baseline). Both treatments significantly reduced UAE throughout the study, but the decrease in UAE associated with I was more pronounced, being evident at week 6 (p = 0.05) and maximal at week 24 end-point (-42 vs -29%, p < 0.01). BNP and Ang II levels were similarly reduced by I and R, while bradykinin increased more with R (+132 vs +86%, p < 0.05).
  
  
  CONCLUSIONS
  These findings showed that in diabetic hypertensive patients with microalbuminuria, despite equivalent BP-lowering effect, I produced a greater antiproteinuric effect than R, which might be due to different intrinsic molecular properties of the two drugs.
authors.affiliation: Centro per l'Ipertensione e la Fisiopatologia Cardiovascolare, Department of Internal Medicine and Therapeutics , Piazzale Golgi 19, 27100 Pavia , Italy +390382526217 ; +390382526259 , r.fogari@unipv.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Fogari
authors.forename: Amedeo
authors.initials: A
authors.lastname: Mugellini
authors.forename: Annalisa
authors.initials: A
authors.lastname: Zoppi
authors.forename: Roberta
authors.initials: R
authors.lastname: Gualtierotti
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Lazzari
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Derosa
authors.forename: Angela
authors.initials: A
authors.lastname: D'Angelo
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis; D000419:Albuminuria / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D000804:Angiotensin II / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D001920:Bradykinin / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D048289:Imidazolidines / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies; D017257:Ramipril / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D000806:Angiotensin-Converting Enzyme Inhibitors; D048289:Imidazolidines; D000804:Angiotensin II; D020097:Natriuretic Peptide, Brain; C065166:imidapril; D017257:Ramipril; D001920:Bradykinin