PMID- 16197662
OWN - NLM
STAT- MEDLINE
DCOM- 20051028
LR  - 20181201
IS  - 0300-7995 (Print)
IS  - 0300-7995 (Linking)
VI  - 21
IP  - 9
DP  - 2005 Sep
TI  - Effect of three months' treatment with irbesartan on blood and pulse pressure of 
      hypertensive type 2 diabetic patients: open, observational study in 31,793 
      patients.
PG  - 1433-40
AB  - OBJECTIVES: In hypertensive diabetics the cardiovascular risk is substantially 
      increased. Therefore, an effective reduction of both blood pressure and pulse 
      pressure is of particular importance for these patients. The aim of the 
      prospective observational study in hypertensive type 2 diabetics was to assess 
      the effect of a switch from the previous antihypertensive therapy to the 
      angiotensin-II-receptor antagonist irbesartan (alone or in combination with HCTZ) 
      on the reduction of blood pressure and pulse pressure, the reduction of diabetic 
      nephropathy (microalbuminuria), and tolerability. METHODS: 8714 general 
      practitioners included 31,793 type 2 diabetics aged at least 18 years in an open 
      observational study. After inclusion in to the study the patients received 
      irbesartan 300 mg as monotherapy or in combination with hydrochlorothiazide 12.5 
      mg (HCTZ). Main outcome measures for efficacy were the reduction of systolic 
      (SBP) and diastolic (DBP) blood pressures, reduction of pulse pressure, and blood 
      pressure responder (reduction in DBP > or = 10 mmHg or diastolic < 90 mmHg), 
      diastolic normalization (DBP < 90 mmHg) and overall normalization rates (SBP < 
      140 mmHg and DBP < 90 mmHg) after 3 months. Further outcome measures included the 
      reduction of microalbuminuria or proteinuria, and adverse events (AEs) as a 
      measure of tolerability. RESULTS: Thirty-eight per cent of patients received 
      irbesartan 300 mg and 61% irbesartan in combination with HCTZ. Mean systolic 
      blood pressure was reduced by 22.5 mmHg, diastolic blood pressure by 10.7 mmHg 
      (baseline values: 160.2 and 93.2 mmHg). Pulse pressure fell on average by 11.6 
      mmHg. 83.4% of the patients were responders, with an overall normalization rate 
      of 42.7% (SBP < 140 mmHg and DBP < 90 mmHg), respectively 73.8% (DBP < 90 mmHg). 
      The antihypertensive benefit was achieved irrespective of the previous 
      medication. Mean albuminuria decreased by about 27.7 mg/L. Only 0.3% of patients 
      experienced adverse events. CONCLUSIONS: In type 2 diabetics with hypertension 
      and either uncontrolled or no previous antihypertensive therapy a change to 
      treatment with irbesartan or irbesartan/HCTZ for 3 months resulted in a distinct 
      reduction of systolic and diastolic blood pressures, with concomitant effective 
      reductions of pulse pressure and microalbuminuria.
FAU - Strutz, F
AU  - Strutz F
AD  - Department of Nephrology and Rheumatology, Georg-August University of Gottingen, 
      Gottingen, Germany. fstrutz@gwdg.de
FAU - Bramlage, P
AU  - Bramlage P
FAU - Paar, W D
AU  - Paar WD
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Biphenyl Compounds)
RN  - 0 (Tetrazoles)
RN  - J0E2756Z7N (Irbesartan)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antihypertensive Agents/administration & dosage/*therapeutic use
MH  - Biphenyl Compounds/administration & dosage/*therapeutic use
MH  - Blood Pressure/*drug effects
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Drug Tolerance
MH  - Female
MH  - Humans
MH  - Hypertension/complications/*drug therapy
MH  - Irbesartan
MH  - Male
MH  - Middle Aged
MH  - Observation
MH  - Prospective Studies
MH  - Tetrazoles/administration & dosage/*therapeutic use
MH  - Treatment Outcome
EDAT- 2005/10/04 09:00
MHDA- 2005/10/29 09:00
CRDT- 2005/10/04 09:00
PHST- 2005/10/04 09:00 [pubmed]
PHST- 2005/10/29 09:00 [medline]
PHST- 2005/10/04 09:00 [entrez]
AID - 10.1185/030079905X61811 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2005 Sep;21(9):1433-40. doi: 10.1185/030079905X61811.