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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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 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?


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


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


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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