Blood pressure drug helps nondiabetics

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Blood pressure drug helps nondiabetics

Emma Hitt, PhD

NEW YORK, Jul 16 (Reuters Health) - A class of blood pressure medications

called ACE inhibitors may help slow the progress of kidney disease in

nondiabetic patients, according to new research.

ACE inhibitors are known to be effective for treating kidney disease in

patients with type 1 diabetes, and evidence is mounting that they help

patients with type 2 diabetes as well. But studies have shown conflicting

results on whether these drugs are helpful for kidney disease patients who

do not have diabetes.

To investigate, researchers led by Tazeen H. Jafar from the Aga Khan

University, Karachi, Pakistan, analyzed 11 previous studies that included

1,860 non-diabetic patients with kidney disease.

The 11 studies all had measured patients' blood pressure and levels of

protein in their urine, an indicator of worsening of kidney disease. They

compared the results of patients who received ACE inhibitors with those of

patients who had received other types of blood pressure medication or an

inactive placebo.

Overall, kidney function in nondiabetic patients was improved in those who

received ACE inhibitors compared with those who received other types of

drugs or an inactive placebo. These patients also showed greater decreases

in blood pressure and urine protein levels.

Patients who began with the highest levels of protein in their

urine--meaning the most severe kidney disease--tended to benefit the most

from ACE inhibitors, the researchers found.

" Our findings have important implications for the use of ACE inhibitors in

clinical practice, " the researchers write in the July 17th issue of the

ls of Internal Medicine, concluding that " ACE inhibitors should be the

antihypertensive agents of first choice in nondiabetic renal disease, as

they are in diabetic renal disease. "

In a related editorial, Dr. W. Schrier and Dr. O. Estacio,

both kidney specialists in Denver, Colorado, note that this study

" importantly contributes evidence on strategies to slow nondiabetic renal

progression with ACE inhibitors. " The authors' conclusions are " exciting "

but should be considered tentatively, the editorialists say.

SOURCE: ls of Internal Medicine 2001;135:73-87,138-139.