[Treatment of hypertension in diabetics with trandolapril, an angiotensin converting enzyme inhibitor--a multicenter study].

Subjects with diabetes mellitus (DM) are high-risk patients because of the cardiovascular morbidity and mortality. A one-year open clinical prospective study took place in 7 centres in the Czech and Slovak Republic in 1996-1997. Aim of the study was treatment of hypertension in patients with DM of both types by the ACE inhibitor trandolapril in dose of 2-4 mg, possibly in combination with the calcium channel blocker verapamil--240 mg. The investigation was completed by 79 patients (60 patients with DM type 2 and 19 with DM type 1). All patients achieved the target blood pressure which in 1997 was also for patients with DM less than 140/90 mm Hg. As good as 20% of the patients achieved these values when treated with 2 mg trandolapril, 52% on a dose of 4 mg and 23% after combined treatment. Only 25% of the patients achieved values lower than 130/85 mm Hg, as recommended in the contemporary recommendations "Prevention of ischaemic heart disease in adult age" published in 1998. On comparison of other risk factors in groups of patients with a BP below 130/85 mm Hg and higher than this borderlimit line it was revealed that one-year treatment of hypertension with trandolapril--4 mg alone or combined with verapamil 240 mg led to a greater reduction of the pulse rate, fasting insulin level, hematicrit and triglycerides and to an increase of HDL-cholesterol. This study revealed that systematic treatment of hypertension by the above mentioned drugs in patients with DM is effective and well tolerated. In addition to reduction of the blood pressure the activity of the sympathetic nervous system was reduced and some metabolic parameters improved.