UNSPECIFIED (1998) Effect of angiotensin-converting enzyme inhibition with perindopril and beta-blockade with atenolol on retinal blood flow in hypertensive diabetic subjects. In: Symposium on ACE Inhibition in Diabetes - Challenging Renal and Vascular Disease, at the 16th International-Diabetes-Federation Congress, JUL 20-25, 1997, HELSINKI, FINLAND.

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Abstract

The effect of angiotensin-converting enzyme (ACE) inhibitors on the diabetic retinal circulation has not been studied previously. The aim of this study was to evaluate the effect of ACE inhibition and beta-blockade on retinal blood flow (RBF) in a group of 45 hypertensive diabetic subjects using a randomized double-blind trial over a period of 12 months. Laser Doppler velocimetry and computed image analysis were used to measure RBF. The changes in blood pressure over 12 months were comparable (perindopril [PE]: systolic [SBP] 152.1 +/- 3.3 and diastolic [DBP] 97.2 +/- 1.7 mm Hg to SEP 136.8 +/- 3.4 and DBP 85.8 +/- 2.1; atenolol: SEP 158.9 +/- 5.1 and DBP 97.5 +/- 1.6 mm Hg to SEP 137.9 +/- 3.4 end DBP 85.1 +/- 1.6; P = .607, mean +/- SEM). RBF decreased from 17.19 +/- 2.21 mu L . min(-1) to 14.18 +/- 1.50 mu L . min(-1) in the PE group (n = 15, P =.208) while it increased with atenolol from 15.80 +/- 1.24 mu L . min(-1) to 16.99 +/- 1.18 mu L . min(-1) (n = 17, P = .399). The comparison of percentage changes in RBF (PE -7.16% +/- 11.49%; atenolol, + 15.31% +/- 9.51%) reached statistical significance (P < .05). There was an increase in RBF in 33.3% of subjects receiving PE and in 70.6% of those receiving atenolol. Similar trends were found for retinal conductance. There were no significant changes in the parameters of retinal vascular permeability. Albuminuria decreased to a greater degree with PE, but did not reach significance (PE, 112.1 +/- 39.5 mg/24 h to 88.6 +/- 30.5 mg/24 h; atenolol, 87.3 +/- 51.7 mg/24 h to 82.1 +/- 47.7 mg/24 hi. This suggests that ACE inhibition therapy may promote a hemodynamic milieu in the hypertensive diabetic retinal circulation that serves to protect against the progression of diabetic retinopathy, whereas beta blockade has the opposite effect. Copyright (C) 1998 by W.B. Saunders Company.

Item Type:	Conference Item (UNSPECIFIED)
Subjects:	R Medicine > RC Internal medicine
Journal or Publication Title:	METABOLISM-CLINICAL AND EXPERIMENTAL
Publisher:	W B SAUNDERS CO
ISSN:	0026-0495
Date:	December 1998
Volume:	47
Number:	12 Suppl. 1
Number of Pages:	6
Page Range:	pp. 28-33
Publication Status:	Published
Title of Event:	Symposium on ACE Inhibition in Diabetes - Challenging Renal and Vascular Disease, at the 16th International-Diabetes-Federation Congress
Location of Event:	HELSINKI, FINLAND
Date(s) of Event:	JUL 20-25, 1997
URI:	http://wrap.warwick.ac.uk/id/eprint/15014

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