The ROADMAP trial: olmesartan for the delay or prevention of microalbuminuria in type 2 diabetes

Abstract

Microalbuminuria is a major target of the therapeutic interventions in clinical trials aimed at assessing whether and to what extent antihypertensive treatment can favor the regression and/or slow down the progression of renal dysfunction in cardiometabolic disease. The Randomized Olmesartan And Diabetes MicroAlbuminuria Prevention (ROADMAP) trial has recently investigated the impact of an angiotensin II receptor blocker (olmesartan) on the new onset of microalbuminuria in type 2 diabetic patients, thus providing direct information on the ability of the drug to prevent the development of this marker of renal organ damage and, more generally, of cardiovascular risk. The results provide evidence that pharmacological blockade of angiotensin II receptors is highly effective in reducing the risk of developing microalbuminuria and that this effect can be achieved through blood-pressure-dependent and blood-pressure-independent effects. Despite the nephroprotective properties of olmesartan, the drug did not reduce the number of cardiovascular events and cardiovascular complications associated with the diabetic state.