Long term impact of RAS inhibition on cardio-renal outcomes: a comparative trial of angiotensin converting enzyme inhibitors, angiotensin receptor blockers or combined therapy with both agents in patients with one or more cardiovascular risk factors and microalbuminuria, diabetic or not diabetic.

This study is looking at whether combining two types of blood pressure and kidney-protecting medicines — an ACE inhibitor and an angiotensin receptor blocker (ARB) — works better than using just one of them alone. The study is for people who have high levels of protein in their urine (which signals kidney stress) and at least one risk factor for heart disease. The goal is to see if combination therapy can better protect the heart and kidneys over the long term. You may be eligible if: - You are 18 years of age or older - You have high levels of protein in your urine (microalbuminuria or macroalbuminuria) - You have one or more cardiovascular risk factors (such as smoking, diabetes, high blood pressure, obesity, high cholesterol, or a family history of heart disease) - If you have had a previous heart attack or stroke, it must have been at least 6 months ago You may NOT be eligible if: - You are pregnant or not using contraception - You have been diagnosed with cancer - You have severe narrowing of the aorta - You have had an allergic or adverse reaction to the study medicines - You have had a major cardiovascular event in the last 6 months - You have a condition that significantly reduces life expectancy Talk to your doctor about whether this trial might be right for you.