{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:32:57Z","timestamp":1769203977756,"version":"3.49.0"},"reference-count":0,"publisher":"American Diabetes Association","issue":"12","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2000,12,1]]},"abstract":"<jats:p>OBJECTIVE: To assess if low (1.25 mg) and\/or standard (5 mg) doses of the ACE inhibitor ramipril could prevent progression of microalbuminuria (incipient diabetic nephropathy) in normotensive type 1 diabetic patients. RESEARCH DESIGN AND METHODS: This study, using a multicenter randomized placebo-controlled double-blind parallel group, was conducted over 2 years in 28 outpatient diabetic clinics in the U.K. and Ireland. We screened 334 type 1 diabetic patients with suspected microalbuminuria and normal blood pressure; of these, 140 patients 18-65 years of age with a diagnosis of type 1 diabetes and persistent microalbuminuria, defined as urinary albumin excretion rate (AER) of 20-200 microg\/min, were enrolled in the study. RESULTS: The proportion of patients progressing to macroalbuminuria was reduced in the ramipril groups but did not reach statistical significance over 2 years. AER was significantly lower at year 2 in the combined ramipril-treated patients versus placebo (P = 0.013). More patients on ramipril regressed to normoalbuminuria (&amp;lt;20 microg\/min), with 11% for 1.25 mg ramipril, 20% for 5 mg ramipril, and 4% for placebo (P = 0.053). Blood pressure was significantly reduced to a similar extent with both 1.25 and 5 mg ramipril. Supine systolic blood pressure increased from 130 to 134 mmHg in the placebo group and fell in the 1.25 mg ramipril group (from 132 to 129 mmHg) and in the 5 mg ramipril group (from 134 to 130 mmHg) (P = 0.003, compared with placebo). No statistically significant changes were observed in glomerular filtration rate (GFR) between the placebo- and ramipril-treated groups during the 2-year period. CONCLUSIONS: Microalbuminuria is reduced significantly by ramipril treatment in type 1 diabetic patients without hypertension. Although the magnitude of the response was greater, there is no significant difference between responses to 1.25 or 5 mg ramipril. Small but highly significant reductions in systolic and mean arterial pressures occur in ramipril-treated patients. GFR is stable at this stage of the evolution of diabetic nephropathy and is unaffected by ramipril treatment for 2 years.<\/jats:p>","DOI":"10.2337\/diacare.23.12.1823","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"1823-1829","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":82,"title":["Low-dose ramipril reduces microalbuminuria in type 1 diabetic patients without hypertension: results of a randomized controlled trial."],"prefix":"10.2337","volume":"23","author":[{"given":"P","family":"O'Hare","sequence":"first","affiliation":[{"name":"Sir Quentin Hazel Institute of Molecular Medicine, University of Warwick, Gibbet Hill, Coventry, CV47AL, England, U.K."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Bilbous","sequence":"additional","affiliation":[{"name":"Sir Quentin Hazel Institute of Molecular Medicine, University of Warwick, Gibbet Hill, Coventry, CV47AL, England, U.K."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Sir Quentin Hazel Institute of Molecular Medicine, University of Warwick, Gibbet Hill, Coventry, CV47AL, England, U.K."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C J","family":"O' Callaghan","sequence":"additional","affiliation":[{"name":"Sir Quentin Hazel Institute of Molecular Medicine, University of Warwick, Gibbet Hill, Coventry, CV47AL, England, U.K."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G C","family":"Viberti","sequence":"additional","affiliation":[{"name":"Sir Quentin Hazel Institute of Molecular Medicine, University of Warwick, Gibbet Hill, Coventry, CV47AL, England, U.K."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Ace-Inhibitor Trial to Lower Albuminuria in Normotensive Insulin-Dependent Subjects Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/23\/12\/1823\/450434\/11128360.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/23\/12\/1823\/450434\/11128360.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T13:15:22Z","timestamp":1647090922000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/23\/12\/1823\/20449\/Low-dose-ramipril-reduces-microalbuminuria-in-type"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12,1]]},"references-count":0,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2000,12,1]]}},"URL":"https:\/\/doi.org\/10.2337\/diacare.23.12.1823","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,12,1]]}}}