The Effect of Combination Treatment of Fosinopril and Losartan on Microalbuminuria in Patients with Essential Hypertension

Objective To evaluate the the effect of microalbuminuria of combined treatment with fosinopril and losartan,or fosinopril,losartan monotherapy in patients with hypertension.Methods In this double-blind, intention to treat study,136 patients with hypertension were randomly assigned to receive fosinopril 10 mg/d(n= 50),losartan 50 mg/d(n=41),or a combination of fosinopril 5 mg and losartan 25 mg (n=45) qd for 4 weeks, followed by titrating to the maximum recommended doses for another 4 weeks.The primary endpoint was the difference of mean sitting blood pressure and microalbuminuria excretion at baseline and week 8.Results At week 8,the combination of fosinopril and losartan therapy lowered mean mieroalbuminuria from baseline by 26.1×10~(-8) mol/L,significantly more than either monotherapy approaches (fosinopril 20 mg,18.3×10~(-8)mol/L,P0.01 or losartan 50 mg,18.5×10~(-8)mol/L,P0.01).Both SBP and DBP were not different among three groups. Conclusion The combination of ACEI and ARB at maximum recommended doses resulted in significantly more de- crease in microalbuminuria than monotherapy with either agent in patients with hypertension.