Abstract | OBJECTIVE: DESIGN: Randomized, placebo-controlled, double-masked and parallel-group trial. SETTING: Academic medical centre. SUBJECTS: Twenty-four type 2 diabetic patients with DMa. INTERVENTION: Subjects were randomly assigned to a 4-month treatment with either losartan (50 mg o.d.) or placebo. MAIN OUTCOME MEASURES: (i) Degree of macular oedema as estimated by optical coherence tomography scanning of the retina; (ii) fundus photography and flourescein angiography; (iii) 24-h ambulatory blood pressure (BP); (iv) urinary albumin excretion (UAE); and (v) transcapillary escape rate of albumin (TERalb). RESULTS: Central retinal thickness increased from 244 +/- 16 to 256 +/- 31 microm in the losartan group, whilst there was no change in the placebo group (245 +/- 36 microm vs. 242 +/- 30 microm), P = 0.017. Day BP were lowered in the losartan group (from 144/83 +/- 17/10 to 138/78 +/- 20/11 mmHg) compared with the placebo group (140/81 +/- 14/5 to 139/82 +/- 13/9 mmHg), P = 0.27 for systolic and P = 0.009 for diastolic BP. Importantly, there were no changes in night BP in any of the groups. We found no changes in the number of hard exudates, semiquantitative retinopathy grade, visual acuity, UAE, or TERalb in any of the groups. CONCLUSIONS: Type 2 diabetic patients with maculopathy do not seem to benefit from short-term treatment with losartan (50 mg once daily) as far as retinal thickness is concerned, as this dose may increase retinal thickness in the central macular area. Long-term studies are required to assess the clinical implications of these findings.
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Authors | S T Knudsen, T Bek, P Løgstrup Poulsen, M Nørgaard Hove, M Rehling, C E Mogensen |
Journal | Journal of internal medicine
(J Intern Med)
Vol. 254
Issue 2
Pg. 147-58
(Aug 2003)
ISSN: 0954-6820 [Print] England |
PMID | 12859696
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Angiotensin Receptor Antagonists
- Losartan
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Topics |
- Aged
- Angiotensin Receptor Antagonists
- Blood Pressure
(physiology)
- Diabetes Mellitus, Type 2
(complications, physiopathology)
- Diabetic Retinopathy
(drug therapy, physiopathology)
- Double-Blind Method
- Female
- Humans
- Losartan
(therapeutic use)
- Male
- Middle Aged
- Tomography
(methods)
- Treatment Outcome
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