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Trial examines the benefits of statin treatment in lowering blood pressure

Global cardio-renal intervention trial sets out to understand the long-term complications of cardiovascular disease in young people with type 1 diabetes.

Drugs used to lower blood pressure and cholesterol levels in adults do not significantly reduce a protein linked to the risk of kidney, eye and cardiovascular disease in young people with type 1 diabetes, a study has found.

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Angiotensin-converting–enzyme (ACE) inhibitors and statins do not considerably lessen the levels of albumin in the urine. A high-level of the protein, albumin, is an indication for the risk of further health complications.

A team across the UK, Canada and Australia led a four-year adolescent type 1 diabetes cardio-renal intervention trial in order to understand the long-term complications in young people with type 1 diabetes.

The study screened 4,407 adolescents with type 1 diabetes between ten and 16 years of age.

Teenagers with low levels of albumin in their urine were considered to be at low risk, and were followed for up to four years (known as the observational arm).

Of those screened, 443 teenagers with high levels of albumin in their urine were invited to join the trial. Known as the intervention arm, they received either a single drug (either ACE inhibitor or a statin), a combination of the two (ACE inhibitor and statin) or placebo.

Although ACE inhibitor therapy, statin therapy, or the combination of the two did not considerably decrease albumin, the use of an ACE inhibitor was associated with a lower incidence of moderate increase in the level of urine albumin than the use of placebo.

The research team has suggested that the impact of ACE inhibitor or statin treatment may be felt later, as seen in other glucose-, lipid-, or blood pressure-lowering trials.  

Marcovecchio ML, Chiesa S, Bond S (2017) ACE Inhibitors and Statins in Adolescents with Type 1 Diabetes. The New England Journal of Medicine. doi: 10.1056/NEJMoa1703518

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