Korean Diabetes J.  2008 Dec;32(6):513-521. 10.4093/kdj.2008.32.6.513.

Effect of Valsartan on Blood Pressure and Urinary Albumin Excretion in Hypertensive Type 2 Diabetic Patients: An Open-Label, Multicenter Study

• Park SJ
• Kim DJ
• Kim HJ
• Park SY
• Seo JA
• Kim NH
• Choi SH
• Lim S
• Jang HC
• Ko SH
• Song KH
• Ahn YB
• Kim SK
• Cho YW
• Kang JG
• Ihm SH
• Park CY
• Park SW
• Shin DH
• Kim YH
• Lee KW

• KMID: 2222459
• DOI: http://doi.org/10.4093/kdj.2008.32.6.513

Abstract

BACKGROUND
Activation of renin-angiotensin system (RAS) has been an important mechanism of microvascular and macrovascular complications in diabetic patients. It has been reported that RAS blockades reduce the development and progression of diabetic nephropathy. The aim of this study was to evaluate whether valsartan, an angiotensin II receptor blocker (ARB), reduced blood pressure and urinary albumin excretion rate (UAER) in hypertensive type 2 diabetic patients. METHOD: Three hundred forty-seven hypertensive type 2 diabetic patients who had not taken angiotensin converting enzyme inhibitors or ARB for 6 months prior to this study were enrolled. We measured blood pressure and UAER before and after 24 weeks of valsartan treatment. RESULT: Baseline mean systolic and diastolic blood pressure was 143 +/- 15 and 87 +/- 11 mmHg, respectively and the median albumin excretion rate was 27 ug/mg. Reduction in systolic and diastolic blood pressure was 16 mmHg/10 mmHg and the median UAER was 19.3 ug/mg after 24 weeks (P < 0.01, respectively). When we divided the subjects into three groups according to the UAER (normoalbuminuria, microalbuminuria and macroalbuminuria), significant changes were reported in the microalbuminuria and the macroalbuminuria groups. Thirty-eight (42%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria. We found an association between the improvement of blood pressure and UAER (R = 0.165, P = 0.015).
CONCLUSION
We concluded that valsartan reduces urinary albumin excretion and blood pressure in hypertensive type 2 diabetic patients.

Keyword

Angiotensin; Blood pressure; Diabetes mellitus; Valsartan

MeSH Terms

Angiotensin-Converting Enzyme Inhibitors
Angiotensins
Blood Pressure
Diabetes Mellitus
Diabetic Nephropathies
Humans
Receptors, Angiotensin
Renin-Angiotensin System
Tetrazoles
Valine
Valsartan
Angiotensin-Converting Enzyme Inhibitors
Angiotensins
Receptors, Angiotensin
Tetrazoles
Valine

Figure

• 

  Fig. 1 Changes in the urinary albumin excretion rate in each albuminuria group. It was noted that the urinary albumin excretion rate reduced in each group after valsartan (or valsartan/chlorthiazide) administration. The values were reported as median. UAER, urine albumin excretion ratio. *P < 0.05, compared to the initial value.

• 

  Fig. 2 Changes of the albuminuria status in each albuminuria group after 24 weeks of valsartan administration. Thirty-eight (43%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria.

• 

  Fig. 3 Correlation between the reduction of systolic blood pressure and urinary albumin excretion rate. Blood pressure reduction was associated with a decreased urinary albumin excretion ratio (R = 0.165, P = 0.015). △SBP, reduction of systolic blood pressure; △UAER, reduction of urinary albumin excretion ratio.

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