Abstract 11026: Effect of Canrenone and Hydrochlorotiazide Addition to Valsartan/Amlodipine Combination on Microalbuminuria in Diabetic Hypertensive Patients
Aim: The aim of this study was to evaluate the effect of canrenone or hydrochlorotiazide (HCTZ) addition to valsartan/amlodipine (V/A) combination on microalbuminuria in diabetic hypertensive patients.
Methods: Hundred twenty hypertensive patients with microalbuminuria and well controlled type 2 diabetes (HbA1c < 7 %) and with blood pressure (BP) not controlled (> 130/80 mmHg) by V 360 mg/A 10 mg combination, after a 2 week placebo period were randomized to canrenone 25 mg or HCTZ 12.5 mg for 2 weeks. After 4 week the doses were doubled in non-responders. BP, microalbuminuria, HbA1c, and K+ were evaluated at the end of the placebo period and at the end of the active period.
Results: BP showed a significant lowering both with HCTZ (-5.6/4.1 mmHg) and canrenone (-5.4/3.9 mmHg) without any significant difference between the 2 treatments. Microalbuminuria was significantly reduced by canrenone (from 95.6 ± 36.3 to 66.2 ± 30.4 mg/24 h, p< 0.01), but not by HCTZ (from 99.3 ± 46.6 to 90.7 ± 35.9 mg/24 h). No clinical side effect was complained by the patients and no significant change was observed in blood chemistry.
Conclusions: In diabetic microalbuminuric hypertensive patients the addition of canrenone, but not of HCTZ to full-dose V/A combination induced a significant decrease in daily microalbuminuria despite the same BP reduction. It suggests that aldosterone antagonism could exert a nephroprotective activity in this type of patients.
- © 2013 by American Heart Association, Inc.