A multinational clinical trial has found that 300-mg doses of irbesartan lowers blood pressure and also delays the onset of kidney disease in people with type 2 diabetes and hypertension.

A total of 590 hypertensive patients with type 2 diabetes and microalbuminuria were studied over a two-year period. They were divided into three groups, which received 150 mg of irbesartan, 300 mg of irbesartan or placebo. The baseline characteristics in the three groups were similar. While blood pressure was similar in all three groups, the incidence of diabetic nephropathy was considerably lower in those taking the drug, especially at the higher dose.

		Incidence of
	Group	Diabetic Nephropathy	Blood Pressure
	150 mg	19 (9.7%)	143/83
	300 mg	10 (5.2%)	141/83
	placebo	30 (14.9%)	144/83

The Scandinavian researchers concluded that the angiotensin-II receptor antagonist irbesartan protects the kidneys independently of its blood-pressure-lowering effect in patients with type 2 diabetes and microalbuminuria.

This type of protective effect is already well known for the ACE inhibitors. However, 10% or more of the people those are prescribed for cannot take them because of side effects (such as cough). These findings suggest that ACE-receptor blockers such as irbesartan are a viable alternative for those who cannot tolerate ACE inhibitors.

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