What is the recommended therapy for hypertension in patients with type 1 diabetes and persistent albuminuria of 120-150 mg/24 hours?

The recommended therapy for hypertension in patients with type 1 diabetes who have persistent albuminuria of 120-150 mg/24 hours is a single agent ACE inhibitor or ARB. This recommendation stems from evidence that these classes of medications offer renal protective effects, which are particularly important in diabetic patients with hypertension and albuminuria.

ACE inhibitors and angiotensin receptor blockers (ARBs) are specifically beneficial because they help reduce glomerular pressure and slow the progression of diabetic nephropathy by decreasing albumin excretion. In patients with diabetes, especially those with signs of kidney damage, controlling blood pressure is vital not only for cardiovascular health but also for protecting kidney function.

In patients with persistent albuminuria, using ACE inhibitors or ARBs has demonstrated a reduction in the progression of kidney disease and a decrease in cardiovascular events. This protective effect makes them the first-line choice for managing hypertension in this specific clinical context, distinguishing them from other antihypertensive agents that do not offer the same renal protective effects.