Rationale and design of a study comparing two fixed-dose combination regimens to reduce albuminuria in patients with type II diabetes and hypertension

George L. Bakris, R. D. Toto, P. A. McCullough

Research output: Contribution to journalArticle

3 Scopus citations


Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD). The early stage of nephropathy is manifested by the presence of low levels of urinary albumin (microalbuminuria or urinary albumin excretion ≥30 and <299 mg/day). Albuminuria is a marker for development of nephropathy in type II diabetes and for increased cardiovascular morbidity and mortality. Recent studies have demonstrated the importance of antihypertensive agents that inhibit the renin-angiotensin-aldosterone (RAA) system to reduce the risk and slow down the progression of renal disease. A new clinical trial, GUARD (Gauging Albuminuria Reduction With Lotrel in Diabetic Patients With Hypertension), is designed to compare the change in urinary albumin to creatinine ratio after 1 year of initial treatment with either amlodipine besylate/benazepril HCI or benazepril HCI/hydrochlorothiazide. Other objectives include a comparison of the proportion of patients who progress to overt diabetic nephropathy and the safety of these two combination therapies in these high-risk patients.

Original languageEnglish (US)
Pages (from-to)139-144
Number of pages6
JournalJournal of Human Hypertension
Issue number2
StatePublished - Feb 1 2005



  • ACE inhibitor
  • Albuminuria
  • Calcium channel blocker
  • Diabetic nephropathy
  • End-stage renal disease
  • Microalbuminuria

ASJC Scopus subject areas

  • Internal Medicine

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