Author(s) |
(a) Turner R, Holman R, Stratton I, Manley S, Frighi V
(b) Hypertension in Diabetes Study group
|
 |
Title(s) |
(a) Hypertension in diabetes study III. Prospective study of therapy of hypertension in type 2 diabetic patients: efficacy of ACE inhibition and β-blockade
(b) Hypertension in Diabetes Study IV. Therapeutic requirements to maintain tight blood pressure control
|
|
Reference(s) |
(a) Diabetic Med 1994;11:773-82
(b) Diabetologia 1995;39:1554-61
|
|
Disease |
Hypertension
|
|
Purpose |
To determine the efficacy and safety of captopril and atenolol in the management of hypertension in diabetic patients, and the effect of this therapy on the development of diabetic complications
|
|
Study design |
Randomised, controlled
|
|
Follow-up |
5 years
|
|
Patients |
758 patients completing 5 years of the study (with a total recruitment of 1148 patients at present). All with type 2 diabetes and borderline to mild hypertension
|
|
Treatment regimen |
Captopril (ACE inhibitor), starting at 25 mg bid and increasing to 50 mg bid if required, or atenolol (beta-blocker), starting at 50 mg daily and increasing to a maximum of 100 mg if required. Some patients were dosed to produce tight control of BP (< 150 mm Hg systolic, < 85 mm Hg diastolic), and other patients were dosed to produce looser BP control (< 180 mm Hg systolic, < 105 mm Hg diastolic)
|
|
Concomitant therapy |
Diabetic therapy with diet, sulphonylurea, insulin or metformin. If necessary, additional antihypertensive therapy with frusemide, slow-release nifedipine, methyldopa or prazosin
|
|
Results |
Captopril and atenolol were equally effective in reducing BP and led to similar incidence of side effects and hypoglycaemic episodes. Patients allocated to atenolol increased their body weight by a mean of 2.3 kg compared to 0.5 kg in those allocated to captopril (p < 0.01). Allocation to atenolol was also associated with small increases in triglyceride, and decreases in LDL and HDL. The ongoing trial is expected to assess the effect of antihypertensive strategies on the development of diabetic complications
|
|
