Choice of ACE inhibitor combinations in hypertensive patients with type 2 diabetes: update after recent clinical trials

Figures & data

Table 1 Advantages of ACE inhibitor/diuretic combination therapy

Improved blood pressure control

Counterbalances renin-angiotensin system activation secondary to diuretic therapy

Reduced risk of electrolyte disorders (eg, hyper- or hypokalemia, hypomagnesemia)

Synergistic antiproteinuric effects, particularly in the presence of high sodium intake

Better therapeutic response in African-American patients

Blunts the adverse metabolic effects induced by the diuretic

Table 2 Advantages of ACE inhibitor-calcium channel blocker combination therapy

Improved blood pressure control

Favorable metabolic effects

Counterbalances the reflex increase in sympathetic nervous activity induced by calcium channel blockers

Reduced vasodilatory edema

Diuretic and natriuretic effects of calcium channel blockers

Synergistic reduction of proteinuria and the rate of decline in glomerular filtration rate

Increased NO production and decreased cytokine production

Improved fybrinolitic balance

Improved arterial distensibility