Telmisartan plus amlodipine is superior to losartan plus amlodipine in reducing microalbuminuria in hypertensive patients with type 2 diabetes, Italian researchers reported.

A team at the University of Pavia studied 240 hypertensive patients with well controlled diabetes (HbA1c less than 7%) and microalbuminuria (urinary albumin excretion rate [UAER] greater than 30 and less than 300 mg/24 hours).

Roberto Fogari, MD, and his colleagues randomized subjects to receive telmisartan 80 mg/amlodipine 2.5 mg (T/A) or losartan 50 mg/amlodipine 2.5 mg (L/A) daily for 52 weeks. At four weeks, doses were titrated upward for patients who did not respond. After 16 weeks, non-responders were given transdermic clonidine (0.1 md/day). At 20 weeks, patients whose microalbuminuria was not controlled were dropped from the study.

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The reduction in UAER was significantly greater in the T/A recipients than in the L/A group (54.9% vs. 38.5%), despite similar decreases in BP.