Management of Albuminuria in Hypertensive Diabetics

A Multicentre Study to Evaluate the Management of Microalbuminuria in Hypertensive Patients With Type 2 Diabetes: Improving Clinical Practice

Multicenter stepped wedge cluster randomized trial of family practice clinics in Quebec and Ontario comparing the effect of introducing a Point of Care testing (POCT) for urine albumin to usual practice on quality of care in hypertensive patients with Type 2 diabetes.

Inclusion Criteria:

• Male or female 18 years and older and able to visit the study sites every 3 months
• T2D patients with ongoing anti-diabetic therapy for at least 5 years
• Uncontrolled hypertension according to 2012 CHEP recommendations for management of hypertension in diabetic patients ( i.e. BP> 130/80 mmHg)
• Able and agreeing to provide informed consent.

Exclusion Criteria:

• Type 1 diabetes patients
• Ongoing therapy with perindopril,
• Known hypersensitivity or allergies to ACEI or sulfonamide derivatives,
• A history of angioedema related or not to previous treatment with ACEI,
• Impaired renal function defined as serum creatinine levels > 177 µmol/L, eGFR <30 mL/min,
• Hyperkalemia or hypokalemia,
• Severe hepatic impairment,
• Use of non-antiarrhythmic agents causing torsade de pointes,
• Pregnant or lactating women, or who are planning to become pregnant,
• Any conditions which may impact on participation according to treating physician.