There are many medications that can be used to treat high blood pressure. If you have side effects from one, be sure to explain this to your doctor. A medication from another class of agents may work better for you. They are now also used to slow the progression of kidney disease in people with type I diabetes. Each glomerulus has a blood vessel that supplies blood to the filter and a separate one that drains the filter.
ACE inhibitors lower the pressure in the glomeruli by relaxing the vessel that drains the filter.
Not all blood pressure-lowering drugs work in both the large vessels and the glomeruli. In research studies, the use of an ACE inhibitor called captopril cut the progression of kidney disease in half in patients with type I diabetes and early kidney disease. ACE inhibitors other than captopril may be equally effective. Captopril has Food and Drug Administration approval for use in people with type I diabetes with overt nephropathy, that is, in those people with dipstick-positive proteinuria. The Association now recommends that people with type I diabetes and microalbuminuria use ACE inhibitors, to protect kidneys at an even earlier stage.