THE EFFECTS OF ENALAPRIL ON NOCTURNAL BLOOD PRESSURE DIPPING

点击翻译按钮获取中文摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Damage to the kidneys can occur after many years of diabetes. Blood pressure (BP) elevation has repeatedly been shown to represent a risk factor for the early development of kidney damage. Studies have shown that the loss of the normal nocturnal BP dipping pattern may signal the development of early kidney damage by preceding the development of microalbuminuria. A class of medications, called angiotensin converting enzyme (ACE) inhibitors, specifically enalapril maleate has been shown to decrease microalbuminuria in the urine of diabetics. Using ambulatory blood pressure monitoring device, type-1 diabetics who have lost normal nocturnal BP dipping pattern and do not have evidence of microalbuminuria will be randomized to be treated with enalapril or placebo for 12 weeks. Thereafter their 24-hour BP and urine analysis will be re-measured to see if the treatment with enalapril can re-establish the normal nocturnal BP dipping pattern. It is hypothesized that if nocturnal dipping pattern can be re-established, this may delay onset of protein in the urine and drastic kidney damage.