Ruggenenti P, Cortinovis M, Parvanova A, et al. - Dual renin–angiotensin system blockade should not be favored over benazepril (angiotensin converting enzyme inhibitor) or valsartan (angiotensin receptor blocker) monotherapy for prevention of microalbuminuria in normoalbuminuric type 2 diabetic patients.

• 612 type 2 diabetic patients with high-normal albuminuria were included.

• Patients were assigned to combined therapy with benazepril (10 mg/day) and valsartan (160 mg/day) or to benazepril (20 mg/day) or valsartan (320 mg/day) monotherapy.

• At comparable blood pressure control, no superior protective effect against progression to microalbuminuria was offered by combined treatment with half of the standard manufacturer-recommended antihypertensive doses of benazepril and valsartan vs monotherapy with full recommended doses of either benazepril or valsartan.

• Similar risk/benefit profiles of study treatments were observed.

• The combination therapy group showed a slight excess of hyperkalemia and hypotension episodes, however, safety and good tolerability of all treatments was evident.