Nephrol Dial Transplant (2001) 16: 85-89
© 2001 European Renal Association-European Dialysis and Transplant Association
Losartan reduces microalbuminuria in hypertensive microalbuminuric type 2 diabetics
on behalf of a Spanish Working Group
Hypertension Clinic, Internal Medicine, Hospital Clinico, Valencia, 1 University of Valencia Health Care Centre of Vallada and 2 Hospital Marina Alta, Denia, Spain
Background. The aim of the present study was to assess the antialbuminuric effect of losartan in a large number of hypertensive type 2 diabetics.
Methods. This was a 6-month, open-label, prospective and multicentre study. A total of 422 patients with type 2 diabetes who were hypertensive [sitting systolic blood pressure (SBP) 
140 mmHg and/or diastolic blood pressure (DBP) 90 mmHg] and microalbuminuric [urinary albumin excretion (UAE) 30–300 mg/day] were eligible for the study. After a 2-week run-in period, patients were placed on losartan 50 mg once a day. If the BP did not reach the desired goal (<140/90 mmHg) after a 4-week period, the losartan dose was doubled. In the absence of control of BP, losartan 50 mg/day+hydroclorothiazide 12.5 mg/day was administrated. Initially and at 12 and 24 weeks of active treatment, BP, UAE, HbA1c and other renal function parameters were evaluated.
Results. A significant decrease in SBP and DBP was observed, as well as in parameters reflecting metabolic control, fasting glucose and HbA1c. UAE also decreased significantly, but the percentage of the variance of change in UAE explained by the changes in SBP and HbA1c was, however, negligible, i.e. 4%. Moreover, small but significant reductions in uric acid, total cholesterol and triglycerides, and an increase in HDL-cholesterol levels were also observed.
Conclusion. Antihypertensive treatment with losartan exerts a beneficial effect on UAE, a benchmark for measuring the efficacy of therapeutic interventions in diabetic nephropathy, by reducing BP and allowing better diabetes control. The role of other mechanisms influencing the favourable outcome, beyond these measured effects, needs to be assessed in further studies.
Keywords: diabetes; hypertension; losartan; microalbuminuria
Correspondence and offprint requests to: Josep Redon, Hypertension Clinic, Hospital Clinico, Avda Blasco Ibañez, 17, 46010 Valencia, Spain.
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