THE EFFECTS OF ENALAPRIL ON NOCTURNAL BLOOD PRESSURE DIPPING

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 糖尿病多年后可能会对肾脏造成损害。血压(BP)升高已被反复证明是早期肾损害的危险因素。研究表明，正常夜间血压下降模式的丧失可能是早期肾损害的信号，因为它先于微量白蛋白尿的发展。一类被称为血管紧张素转换酶(ACE)抑制剂的药物，特别是马来酸依那普利，已被证明可以减少糖尿病患者尿微量蛋白尿。 使用动态血压监测设备，失去正常夜间血压下降模式且没有微量蛋白尿证据的1型糖尿病患者将随机接受依那普利或安慰剂治疗12周。此后，将重新测量他们的24小时血压和尿液分析，以确定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，如果能够重新建立夜间的浸泡模式，这可能会推迟尿中蛋白质的出现和严重的肾脏损害。

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 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.