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Blood Pressure-Reducing Medication May Protect Kidney in Diabetes

by Dr. Nithin Jayan on  March 15, 2011 at 6:55 PM Health Watch   - G J E 4
Blood pressure-reducing medication olmesartan may help protect the kidneys of people with type 2 diabetes, suggests study.
Kidney is one of the worst affected organs in long standing diabetes. Diabetic nephropathy is a major complication of uncontrolled high blood sugar. Filtering units of the kidney called nephrons are damaged in this condition leading to the leakage of proteins (albumin) in urine. The possibility of kidney function problems can hence be assessed by measuring the amount of albumin secreted in the urine (microalbuminuria). Preventing renal disease is of utmost importance in improving the life span of diabetics.

In a major study involving 4447 patients with type 2 diabetes an international team of researchers found that olmesartan could increase the time before any kidney problems were evident by 23%. The drug was associated with a delayed onset of microalbuminuria. Olmesartan is part of a major class of drugs known as angiotensin II receptor blockers or ARBs. These drugs lower blood pressure by relaxing blood vessels. They are efficient anti hypertensives. Olmesartan has been in vogue since its approval in 2002.

The study included 4,447 people with type 2 diabetes at 262 centres in 19 European countries. It was a randomised controlled trial that assigned these patients to receive olmesartan or placebo for a median of 3.2 years. Results were published in the New England Journal of Medicine.

"Olmesartan was associated with a delayed onset of microalbuminuria, even though blood-pressure control in both groups was excellent according to current standards," wrote the study's authors.

The study also breaks the bad news about the association of the drug with heart disease. More patients in the treatment group receiving olmesartan had fatal cardiovascular events compared to those in the placebo group. However the benefits of the drug likely outweigh the potential risk.

The latest trials add to the confidence that health care providers lay on ARBs. Previous studies had shown that ARBs prevent the onset of type 2 diabetes.

Reference: Olmesartan for the Delay or Prevention of Microalbuminuria in Type 2 Diabetes, Hermann Haller, M.D., Sadayoshi Ito, M.D., Ph.D., Joseph L. Izzo, Jr., M.D., Andrze Januszewicz, M.D., Shigehiro Katayama, M.D., Ph.D., Jan Menne, M.D., Albert Mimran, M.D., Ton J. Rabelink, M.D., Ph.D., Eberhard Ritz, M.D., Luis M. Ruilope, M.D., Lars C. Rump, M.D., and Giancarlo Viberti, M.D. for the ROADMAP Trial Investigators. N Engl J Med 2011; 364:907-917, March 10, 2011.

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