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METHODS: Patients with elevated clinic BP and ambulatory daytime BP ³130/85 mm Hg were randomised to AML 5-10 mg (n=47) or LOS 50-100 mg (n=47). HCTZ and other antihypertensive agents excluding ACE inhibitors were added in order to reach target clinic BP< 130/85 mmHg. Clinic and ambulatory BP, UAE and glomerular filtration rate (GFR) were assessed at baseline and during the 3-year period.

RESULTS: Both treatment groups exhibited significant and similar decreases in systolic/diastolic clinic (@ –25/–15 mm Hg) BP. Systolic/ diastolic ambulatory BP were also significantly reduced by both treatments during the daytime (@ –20/-13 mm Hg) and the night-time (@ –14/-9 mm Hg) periods. UAE was similarly decreased by both AML-based (from 26.47 to 16.26 µg/min) and LOS-based (from 16.46 to 7.46 µg/min) treatment regimens. Five NA patients (3 on AML, 2 on LOS) developed MA while one patient (AML group) developed MA. In contrast, 9 out of 25 patients and 9 out of 16 patients respectively treated with AML and LOS regressed to NA from MA. GFR was significantly decreased by both AML (from 98.4±2.6 to 91.3±3.3 ml/min) and LOS (from 94.1±2.6 to 83.0±3.5 ml/min) regimens during the first 24 weeks of treatment but remained stable thereafter.