THE EFFECTS OF ENALAPRIL ON NOCTURNAL BLOOD PRESSURE DIPPING

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。多年的糖尿病会对肾脏造成损害。血压（BP）升高已多次被证明是肾脏损害早期发展的一个危险因素。研究表明，正常夜间血压下降模式的丧失可能预示着早期肾损害的发生，早于微量白蛋白尿的发生。一类被称为ACE抑制剂的药物，特别是马来酸依那普利已经被证明可以减少糖尿病患者尿中的微量白蛋白尿。使用动态血压监测装置，失去正常夜间血压下降模式且无微量白蛋白尿证据的1型糖尿病患者将被随机分配使用依那普利或安慰剂治疗12周。之后，他们的24小时血压和尿液分析将被重新测量，以观察依那普利治疗是否能重建正常的夜间血压下降模式。据推测，如果夜间尿浸模式可以重新建立，这可能会延迟尿中蛋白质的发生和严重的肾脏损害。

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 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.