THE EFFECT OF CARVEDILOL AND METOPROLOL ON PROTEINURIA AND ENDOTHELIAL FUNCTION

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。这是一项试验性研究，旨在确定卡维地洛与血管紧张素转换酶抑制剂联合使用时，在减少糖尿病肾病患者的白蛋白排泄和改善内皮功能方面是否优于美托洛尔。在基线和随机用药后12周结束时，将进行以下评估：1.白蛋白排泄率；2.内皮功能。如果这种疗法成功，它将为我们提供另一种使用联合疗法来治疗糖尿病肾病的方法，这些人群是心血管疾病和透析的高危人群。前臂血流研究还将让我们进一步了解，尽管接受了血管紧张素转换酶抑制剂的治疗，非裔美国人的2型糖尿病是否与内皮功能障碍有关，这种功能障碍是否与一氧化氮的产生或作用缺陷有关，以及是否可以用卡维地洛等药物纠正。

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. This is a pilot study to determine whether Carvedilol is superior to Metoprolol when used in combination with an ACE inhibitor in decreasing albumin excretion, and improving endothelial function in patients with diabetic nephropathy. At baseline and at the end of 12 weeks after randomization to either drug the following assessments will be made: 1. Albumin excretion rate; 2. Endothelial function. If this therapy is successful it will provide us with an additional way to use combination therapy to treat diabetic nephropathy in a population that is at high risk for cardiovascular disease and dialysis. The forearm blood flow studies will also give us further insight into whether type 2 diabetes in African-Americans is associated with endothelial dysfunction despite treatment with ACEIs and whether this dysfunction is related to a defect in nitric oxide production or action, and whether it is amenable to correction with drugs like Carvedilol.