OBJECTIVE: Many @entity1 with @entity2316 ( @entity2316 ) have levels of @entity633 > 1 g/day and blood pressure >135/85 mmHg, despite antihypertensive combination therapy, including recommended doses of @entity1289 inhibitors, e.g., lisinopril/ @entity4688 at 20 mg daily. We tested the concept that such @entity1 might benefit from dual blockade of the renin-angiotensin system (RAS). RESEARCH DESIGN AND METHODS: We performed a randomized double-blind crossover study of 2 months treatment with @entity1564 cilexetil 8 mg once daily and placebo in addition to previous antihypertensive treatment. We included 18 type 2 @entity6 @entity1 with @entity2316 fulfilling the above-mentioned criteria. All received recommended doses of @entity1289 inhibitor and, in addition, 15 @entity1 received diuretics, 11 received a @entity460 channel antagonist, and 3 received a beta-blocker. At the end of each treatment period, we measured the glomerular filtration rate (GFR), 24-h blood pressure, @entity633 , and IgGuria. RESULTS: The addition of candesartan to usual antihypertensive therapy induced a mean (95% CI) reduction in @entity633 of 25% (2-58), P = 0.036 (geometric mean [95% CI] from 1,764 mg/24 h [1,225-2,540] to 1,334 mg/24 h [890-1,998]). It also produced a mean reduction of 35% (9-53) in the fractional clearance of albumin (P = 0.016), a reduction of 32% (1-54) in fractional clearance of IgG (P = 0.046), a reduction in 24-h systolic blood pressure of 10 mmHg (2-18) (P = 0.019) (mean +/- +/- SE) from 148 +/- 3 to 138 +/- 5 mmHg, and a mean reduction in GFR of 5 ml. min(-1). 1.73 m(-2) (0.1-9) (P = 0.045). CONCLUSIONS: Dual blockade of the RAS reduces @entity633 and blood pressure in type 2 @entity6 @entity1 with @entity2316 responding insufficiently to previous antihypertensive therapy, including @entity1289 inhibitors in recommended doses.

Dual blockade of the renin-angiotensin system in XXXX : a randomized double-blind crossover study.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity4688 :: ('MESH:D004656', 'Chemical') :: ['enalapril'] @entity1289 :: ('1636', 'Gene') :: ['ACE'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic'] @entity2316 :: ('MESH:D003928', 'Disease') :: ['diabetic nephropathy', 'DN'] @entity1564 :: ('MESH:C081643', 'Chemical') :: ['candesartan'] @entity633 :: ('MESH:D000419', 'Disease') :: ['albuminuria'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium']
@entity2316 :: (MESH:D003928,Disease) :: ['diabetic nephropathy']
