BENEDICT – BErgamo NEphrologic DIabetic Complications Trial
Authors:
prof. MUDr. Jindřich Špinar, CSc.; Fesc 1; Prof. MUDr. Jiří Vítovec, CSc.; Fesc 2
Authors‘ workplace:
Interní kardiologická klinika, FN Brno-Bohunice
1; I. interní kardioangiologická klinika
FN U sv. Anny, Brno
2
Published in:
Kardiol Rev Int Med 2005, 7(4): 201-204
Category:
Editorial
Overview
BENEDICT study- BErgamo NEphrologic DIabetic Complications Trial- was aimed at the prevention and the control of microalbuminuria in hypertonics – II type diabetics with normal renal functions. Persistent microalbuminuria developed at 17 of 300 patients treated with the combination of trandolapril + verapamil (5,7 %), at 30 of 300 patients treated with placebo (10,0 %), at 18 of 301 patients treated only with trandolapril (6,0 %) and at 36 of 303 patients (11,9 %) (all < 0,01 trandolapril vs placebo and ns placebo vs verapamil). Combination treatment trandolapril + verapamil significantly decreased the occurence of microalbuminuria at the patients with hypertension and diabetes mellitus in comparison with placebo. Trandolapril alone decreased the occurrence of microalbuminuria, while verapamil had no effect in this way. At the patients with hypertension, diabetes mellitus and normal renal functions, ACE‑inhibitors are the choice drug for blood pressure control.
Key words:
diabetes mellitus - hypertension – microalbuminuria – trandolapril - verapamil
Sources
1. Branett AH, Bain SC, Bouter P et al. Angiotensin receptor blockade versus concertiny enzyme inhibition in type 2 diabetes and nefropathy. NEJM 2004; 351(19): 1952–61.
2. Brenner BM, Cooper ME, Zeeuw D for the RENAAL investigators. RENAAL: Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan. Effects of Losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345: 861-869.
3. Cífková R, Horký K, Widimský J sr et al. Doporučení diagnostických a léčebných postupů u arteriální hypertenze – verze 2004. Doporučení České společnosti pro hypertenzi. Vnitř lék 2004; 50(9): 709-22.
4. Dahlof B, Devereux RB, Kjeldsen SE for the LIFE investigators. Cardovascular morbidity and mortality in the Losartan Intervention For Endpoints reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995-1003.
5. Fox K et al (on behalf of the EUROPA Investigators). Cardiovascular Morbidity and Mortality in Patients With Diabetes in the EUROPA Study: Results From the PERSUADE Substudy, The congress of the American College of Cardiology, New Orleans, USA, 10. March 2004.
6. Chobanian AV, Bakris GL, Black HR. National heart, lung and blood institute joint national committee on prevention, detection, evaluation and treatment of high blood pressure – Seventh report. JAMA 2003; 291: 2560-72.
7. Jones DW, Hall JE. Seventh report of the Joint National Committe on Prevention, Detection, Evaluation and Treatment of High Blood přessure and evidence from new hypertension trials. Hypertension 2004; 43: 1-3.
8. Jacob S, Henriksen EJ, Fogt DL et al. Effects of trandolapril and verapamil on glucose transport in insulin resistant skeletal muscle. Metabolism 1996; 45: 535-41.
9. Lewis EJ, Hunsicker LG, Clarke WR, for the IDNT investigators. IDNT - Irbesartan Diabetic Nephropathy Trial. Renoprotective effect of the angiotensin-receptor antagonist Irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345: 851-860.
10. Lithell H, Hansson L, Skoog I et al. The study on cognition and prognosis in the elderly (SCOPE): principal results of a randomised double-blind interventional trial. J Hyperten 2003; 21: 875-86.
11. Lopez-Sendon J, Swedberg K, McMurray J et al. Expert consensus document on angiotenzin converting enzyme inhibitors in cardiovascular disease. Eur Heart J 2004; 25: 1454-70.
12. Parving HH, Lehnert H, Mortensen JB for the IRMA investigators. IRMA - The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 345: 870-878.
13. Pepine CJ for the INVEST investigators. INVEST: International Verapamil SR/Trandolapril Study. JAMA 2003; 290: 2805-16.
14. Ruggenenti P, Ilieva AP, Bruno S for the BENEDICT investigators. Preventing Microalbuminuria in Type 2 Diabetes. NEJM 2004; 351(19): 1941–61.
15. Špinar J, Vítovec J, Zicha J. Hypertenze - diagnostika a léčba. Praha: Grada Publishing 1999.
16. The UKPDS investigators. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes mellitus: UKPDS 38. BMJ 1998; 317: 703-713.
17. The ALLHAT Officers ond Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in in high-risk hypertensive patients randomised to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic; the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288: 2981-2997.
18. The HOPE investigators. Effects of angiotensin-converting-enzyme inhibitor ramipril, on cardiovascular events in high-risk patients. NEJM 2000; 342: 145-53.
19. The EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-contolled, multicentre trial (the EUROPA study). Lancet 2003; 362: 782-8.
20. The PEACE investigators. Angiotensin-converting-enzyme inhibition in stable coronary artery disease. A Engl J Med 2004; 351: 2058-68.
21. Vítovec J, Špinar J. Hypertension and combination drug therapy. Cor Vasa 2000; 42(9): 461-467.
22. Vítovec J, Špinar J. Farmakoterapie kardiovaskulárních onemocnění. Praha: Grada Publishing 2004.
23. Widimský J et al. Hypertenze. Praha: Triton 2004.
24. Wlliams B, Poulter NR, Brown JM et al. British Hypertension Society guidelines for hypertension management 2004 (BHS-IV). BMJ 2004; 328: 634-40.
25. Zanchetti A for the guidelines committee. 2003 European Society of Hypertension – European Society of Cardiology guidelines for the management of arterial hypertension. J Hyperten 2003; 21: 1011-23.
Labels
Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
Cardiology Review
2005 Issue 4
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