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Drug Delays Microalbuminuria in Type 2 Diabetes

But olmesartan is associated with higher risk of fatal cardiovascular events

WEDNESDAY, March 9 (HealthDay News) -- Olmesartan, an angiotensin-receptor blocker, delays the onset of microalbuminuria in people with type 2 diabetes, but it also appears to be associated with an increased risk of fatal cardiovascular events, according to research published in the March 10 issue of the New England Journal of Medicine.

Hermann Haller, M.D., of Hannover Medical School in Germany, and colleagues randomized 4,447 patients with type 2 diabetes and normoalbuminuria to olmesartan or placebo for a median of 3.2 years to see whether olmesartan would delay or prevent microalbuminuria in this patient population.

The researchers found target blood pressure to be achieved by 80 and 71 percent of the olmesartan and placebo groups, respectively. Time to onset of microalbuminuria, which occurred in 8.2 percent of the treatment group and 9.8 percent of the placebo group, was 23 percent longer in the olmesartan group. Nonfatal cardiovascular events occurred slightly less frequently in the treatment group than the placebo group (3.6 versus 4.1 percent; P = 0.37), but fatal cardiovascular events happened more frequently in the treatment group (0.7 versus 0.1 percent; P = 0.01). This difference was attributable in part to a higher rate of death from cardiovascular causes in the treatment group than in the placebo group among patients with preexisting coronary heart disease.

"Olmesartan was associated with a delayed onset of microalbuminuria, even though blood-pressure control in both groups was excellent according to current standards. The higher rate of fatal cardiovascular events with olmesartan among patients with preexisting coronary heart disease is of concern," the authors write.

The study was supported by Daiichi Sankyo; several authors disclosed financial relationships with Daiichi Sankyo and/or other pharmaceutical companies. The editorial author disclosed financial relationships with several publishing companies.

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