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  • Combination therapy with candesartan and lisinopril was more effective than monotherapy in type 2 diabetes and hypertension

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Therapeutics
Combination therapy with candesartan and lisinopril was more effective than monotherapy in type 2 diabetes and hypertension

https://doi.org/10.1136/ebm.6.4.109

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    (2000) BMJ 321, 1440. Mogensen CE, Neldam S, Tikkanen I, et al.. for the CALM Study Group. Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study.. Dec 9;. :. –4.
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 QUESTION: What are the effects of candesartan or lisinopril, or both, on blood pressure and the urinary albumin excretion rate in patients with hypertension, microalbuminuria, and type 2 diabetes mellitus?

    Design

    Randomised (unclear allocation concealment*), double blind (investigators and patients),* controlled trial with 24 weeks follow up.

    Setting

    37 centres in tertiary hospitals and primary care sites (12 in Australia, 9 in Denmark, 4 in Finland, and 12 in Israel).

    Patients

    199 patients between 30 and 75 years of age with type 2 diabetes, microalbuminuria (urinary albumin to creatinine ratio between 2.5 and 25 mg/mmol), and diastolic blood pressure (BP) between 90 and 110 mm Hg while receiving placebo. Exclusion criteria included body mass index ≥40 kg/m2, systolic BP >200 mm Hg, non-diabetic cause of secondary hypertension, cardiovascular event in the previous 6 months, increased serum creatinine and potassium concentrations, and haemoglobin A1c concentrations >10%. 197 patients (99%) (mean age 60 y, 65% …

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    Footnotes

    • Source of funding: AstraZeneca, Mölndal, Sweden.

    • For correspondence: Dr C E Mogensen, Kommunehospitalet, University Hospital, DK-8000 Aarhus C, Denmark. Fax +45 8949 2010.

    • ↵* See glossary.