RESUMO
The influence of alacepril (50 mg/day) on arterial blood pressure and microproteinuria in 26 hypertensive non-insulin-dependent diabetic patients was studied for 16 weeks. Alacepril reduced blood pressure gradually from 175/88 (standard error of mean [SEM] 2.6/1.7) to 152/81 (3.3/2.0) mm Hg (P less than .005) and albuminuria from 160.6 (SEM 29.1) to 98.1 (14.1) mg/g Cr (P less than .05), while serum blood urea nitrogen, creatinine, HbA1c, and fructosamine (FRA) remained stable. No significant changes occurred in the urinary beta 2 microglobulin and N-acetyl-beta-D-glucosaminidase levels. As compared with the effects of a calcium antagonist (nicardipine, 60 mg/day) that reduced blood pressure from 170/92 (SEM 2.5/1.4) to 154/84 (2.5/1.5) mm Hg (P less than .001) and albuminuria from 162.2 (SEM 33.9) to 95.4 (25.0) mg/g Cr (not significant), it is suggested that the angiotensin-converting enzyme inhibitor (alacepril) may have an advantageous renal effect in spite of its mild antihypertensive effect.
