Effect of enalapril on the incidence of retinopathy in normotensive patients with type 2 diabetes

Two hundred and fifty patients with diabetes mellitus type 2, normal blood pressure, normal kidney function and normo- or microalbuminuria were included in two prospective, controlled studies of 5- and 6-year duration. The patients were randomized to receive enalapril 10 mg/day or placebo. Annual opthalmoscopic examinations were performed, and new cases of diabetic retinopathy were recorded. During the study, retinopathy was found in 9/126 (7.1%) patients assigned to enalapril versus 23/124 (18.5%) patients on placebo, an absolute risk reduction of 11.5% (CI 6-27%, P=0.024). We conclude that, in addition to the effects that ACE inhibitors are already known to have on albuminuria, treatment with them may retard diabetic retinopathy. Further studies are needed to establish this effect. (C) 2000 Elsevier Science B.V.