Antihypertensive therapy in experimental diabetes

Systemic hypertension is an important risk factor for the progression of diabetic glomerular disease. Recognition of this detrimental aspect has prompted intensive investigation into the mechanisms by which systemic hypertension promotes diabetic glomerulopathy, as well as into potential benefits of antihypertensive therapy. Studies in diabetic rats, both normotensive and hypertensive, have established that certain antihypertensive regimens effectively slow the development of albuminuria and glomerular sclerosis. Most consistently effective have been angiotensin-converting enzyme inhibitors, which may act to protect the kidney by several different mechanisms. Other antihypertensive regimens have been less consistent.