There was no change in blood pressure variability in either group. Certain measurements increased with ACE inhibitor infusion but then dropped below study start. This suggests that enzyme systems are involved that are independent from the classic angiotensin forming pathways. The lack of change in blood flow or in blood pressure variability suggests that these are not a reflex response to ACE inhibitor-caused vasodilation. Enalapril prevents clinical proteinuria in diabetic patients with low ejection fraction.
Proteinuria is a risk factor for both kidney disease and heart disease.
The effect of ACE inhibitors in preventing proteinuria in diabetic and non-diabetic heart failure patients is not known. Patients with proteinuria also had higher rates of hospitalization for CHF and higher mortality. Enalapril prevented proteinuria in diabetic patients but not in nondiabetic patients without proteinuria at study start. Clinical proteinuria is an independent predictor of hospitalization for CHF and mortality, in diabetic and nondiabetic CHF patients. Enalapril significantly reduces the risk of proteinuria in diabetic CHF patients.