Combination Therapy for Hypertension and Renal Disease in Diabetes

  • Imelda P. Villarosa
  • George L. Bakris


More than 75% of individuals with diabetes, microalbuminuria and hypertension require two or more antihypertensive medications to attain the currently recommended level of arterial pressure control i.e., substantially less than 130/85 mmHg [1–3]. To achieve this Mood pressure goal, it is common to add a medication whose antihypertensive action potentiates the initially selected drug [4,5]. To further improve compliance and reduce drug side effect profiles, fixed-dose combinations of antihypertensive drugs with complementary modes of action have been recently developed [5]. These medications combine a lower dose of two different antihypertensive drugs that, in a fixed dose combination, reduce arterial pressure to a greater extent compared to either alone. The history of various fixed-dose antihypertensive drug combinations is shown in Table 52–1. The evolution of fixed-dose combination antihypertensive therapy is beyond the scope of this chapter. The reader, however, is referred to a recent review on the topic [5]. This chapter will focus on the available evidence from both animal models of hypertension and renal disease as well as clinical studies that examine the efficacy of different classes of antihypertensive medications, either alone or combined, to either halt or prevent development of renal disease. The discussion will primarily, but not exclusively, focus on angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers (CCBs).


Diabetic Nephropathy Angiotensin Converting Enzyme Angiotensin Converting Enzyme Inhibitor Calcium Channel Blockade Antiproteinuric Effect 
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Copyright information

© Springer Science+Business Media Dordrecht 1998

Authors and Affiliations

  • Imelda P. Villarosa
    • 1
  • George L. Bakris
    • 1
  1. 1.The Rush Hypertension CenterRush Presbyterian/St Luke’s Medical CenterChicagoUSA

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