고혈압을 동반한 제2형 당뇨병환자에서 Valsartan이 혈압과 요중 알부민 배설량에 미치는 영향: 다기관 투약전후 비교 공개 임상연구 (Effect of Valsartan on Blood Pressure and Urinary Albumin Excretion in Hypertensive Type 2 Diabetic Patients: An Open-Label, Multicenter Study)

서지정보

· 발행기관 : 대한당뇨병학회
· 수록지 정보 : Diabetes and Metabolism Journal / 32권 / 6호 / 513 ~ 521페이지
· 저자명 : 박세준, 김대중, 김혜진, 박수연, 서지아, 김난희, 최성희, 임수, 장학철, 고승현, 송기호, 안유배, 김수경, 조용욱, 강준구, 임성희, 박철영, 박성우, 신동현, 김용현, 이관우

초록

Background: Activation of renin-angiotensin system (RAS) has been an important mechanism of
microvascular and macrovascular complications in diabetic patients. It has been reported that RAS blockades
reduce the development and progression of diabetic nephropathy. The aim of this study was to evaluate
whether valsartan, an angiotensin II receptor blocker (ARB), reduced blood pressure and urinary albumin
excretion rate (UAER) in hypertensive type 2 diabetic patients.
Method: Three hundred forty-seven hypertensive type 2 diabetic patients who had not taken angiotensin
converting enzyme inhibitors or ARB for 6 months prior to this study were enrolled. We measured blood
pressure and UAER before and after 24 weeks of valsartan treatment.
Result: Baseline mean systolic and diastolic blood pressure was 143 ± 15 and 87 ± 11 mmHg, respectively
and the median albumin excretion rate was 27 ug/mg. Reduction in systolic and diastolic blood pressure
was 16 mmHg/10 mmHg and the median UAER was 19.3 ug/mg after 24 weeks (P < 0.01, respectively).
When we divided the subjects into three groups according to the UAER (normoalbuminuria,
microalbuminuria and macroalbuminuria), significant changes were reported in the microalbuminuria
and the macroalbuminuria groups. Thirty-eight (42%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria. We
found an association between the improvement of blood pressure and UAER (R = 0.165, P = 0.015).
Conclusion: We concluded that valsartan reduces urinary albumin excretion and blood pressure in
hypertensive type 2 diabetic patients. (KOREAN DIABETES J 32:513-521, 2008)

영어초록

Background: Activation of renin-angiotensin system (RAS) has been an important mechanism of
microvascular and macrovascular complications in diabetic patients. It has been reported that RAS blockades
reduce the development and progression of diabetic nephropathy. The aim of this study was to evaluate
whether valsartan, an angiotensin II receptor blocker (ARB), reduced blood pressure and urinary albumin
excretion rate (UAER) in hypertensive type 2 diabetic patients.
Method: Three hundred forty-seven hypertensive type 2 diabetic patients who had not taken angiotensin
converting enzyme inhibitors or ARB for 6 months prior to this study were enrolled. We measured blood
pressure and UAER before and after 24 weeks of valsartan treatment.
Result: Baseline mean systolic and diastolic blood pressure was 143 ± 15 and 87 ± 11 mmHg, respectively
and the median albumin excretion rate was 27 ug/mg. Reduction in systolic and diastolic blood pressure
was 16 mmHg/10 mmHg and the median UAER was 19.3 ug/mg after 24 weeks (P < 0.01, respectively).
When we divided the subjects into three groups according to the UAER (normoalbuminuria,
microalbuminuria and macroalbuminuria), significant changes were reported in the microalbuminuria
and the macroalbuminuria groups. Thirty-eight (42%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria. We
found an association between the improvement of blood pressure and UAER (R = 0.165, P = 0.015).
Conclusion: We concluded that valsartan reduces urinary albumin excretion and blood pressure in
hypertensive type 2 diabetic patients. (KOREAN DIABETES J 32:513-521, 2008)

참고자료

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