{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T02:15:27Z","timestamp":1777342527798,"version":"3.51.4"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:p>\n            We aimed to test the hypothesis that treatment with enalapril and folic acid is more effective in preventing new-onset proteinuria than enalapril alone among hypertensive patients. This is a post hoc analysis of the renal substudy of the CSPPT (China Stroke Primary Prevention Trial). A total of 13 071 eligible participants without proteinuria were randomized to receive a double-blind daily treatment of a single tablet containing 10-mg enalapril and 0.8-mg folic acid (n=6511) or 10-mg enalapril alone (n=6560). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of \u22651+ at the exit visit. Secondary outcomes included a composite of the primary outcome and all-cause death and the annual rate of estimated glomerular filtration rate decline. After a median 4.4 years of treatment, the primary event occurred in 213 (3.9%) and 188 (3.5%) participants, respectively, in the enalapril and the enalapril\u2013folic acid group (odds ratio, 0.90; 95% confidence interval, 0.74\u20131.11). However, among participants with diabetes mellitus at baseline, folic acid therapy resulted in a significant reduction in the risk for the primary event (3.7% in the enalapril\u2013folic acid group versus 7.4% in the enalapril group; odds ratio, 0.48; 95% confidence interval, 0.29\u20130.81) and the composite event (odds ratio, 0.62; 95% confidence interval, 0.42\u20130.92) and a 55% slower annual rate of estimated glomerular filtration rate decline (0.5% versus 1.1% per year;\n            <jats:italic>P<\/jats:italic>\n            =0.002). Among those without diabetes mellitus at baseline, there were no between-group differences in all the outcomes. In conclusion, enalapril\u2013folic acid therapy, compared with enalapril alone, significantly reduced the development of proteinuria in diabetic patients with hypertension.\n          <\/jats:p>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.ClinicalTrials.gov\">http:\/\/www.ClinicalTrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00794885.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/hypertensionaha.117.09404","type":"journal-article","created":{"date-parts":[[2017,6,13]],"date-time":"2017-06-13T01:00:23Z","timestamp":1497315623000},"page":"300-306","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive Patients"],"prefix":"10.1161","volume":"70","author":[{"given":"Youbao","family":"Li","sequence":"first","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Liang","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guobao","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binyan","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingli","family":"He","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genfu","family":"Tang","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delu","family":"Yin","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Xu","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Huo","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health Administration,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimin","family":"Cui","sequence":"additional","affiliation":[{"name":"From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health 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Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); Department of Neurology, First People\u2019s Hospital, Lianyungang, China (M.H.); Institute for Biomedicine (G.T.) and Department of Health 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Post Hoc Analysis of the Renal Substudy of CSPPT (China Stroke Primary Prevention Trial)"],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1161\/HYPERTENSIONAHA.117.09404"],"URL":"https:\/\/doi.org\/10.1161\/hypertensionaha.117.09404","relation":{},"ISSN":["0194-911X","1524-4563"],"issn-type":[{"value":"0194-911X","type":"print"},{"value":"1524-4563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]},"assertion":[{"value":"2017-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}