MARVAL: MicroAlbuminuria Reduction With Valsartan

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MARVAL MicroAlbuminuria Reduction With Valsartan

• Objective To assess the effects on UAER
  (independent of BP reduction) of valsartan
  treatment in patients with type 2 diabetes and
  microalbuminuria in comparison with amlodipine
  treatment
• Methods 332 patients 35-75 years with type 2
  diabetes and microalbuminuria, with or without
  hypertension
• Valsartan 80 mg od (n169) or amlodipine 5 mg od
  (n163) for 24 weeks
• Target blood pressure 135/85 mm Hg

Viberti et al, Circulation. 2002106672-678
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Mean BP Effects in Type 2 Diabetic Patientswith
MicroAlbuminuria (MARVAL)
Valsartan
Amlodipine
Mean ? from baseline (mm Hg) at 24 weeks
-11.2
-6.6
-11.6
-6.5
SBP
DBP
Viberti et al, Circulation. 2002106672-678
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MARVAL MicroAlbuminuria Reduction With Valsartan
20
UAER change from baseline
-8
0
Amlodipine
-20
-44
-40
Valsartan
-60
0
4
8
12
18
24
Weeks
P lt 0.001
Viberti et al, Circulation. 2002106672-678
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MARVAL MicroAlbuminuria Reduction With Valsartan
of Patients Returning to Normoalbuminuria
Status
35
Valsartan Amlodipine
29.9
30
25
20
14.5
15
10
5
0
Defined as UAER lt 20 ?g/min
P0.001 vs. amlodipine
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MARVAL Conclusions

• Significant reduction in UAER with valsartan vs.
  amlodipine
• reductions observed in groups with / without
  hypertension
• More valsartan patients returned to normal levels
  of albumin in urine after 24 weeks than
  amlodipine patients
• BP reduction comparable between groups
• For same BP reduction, valsartan was
  significantly more effective in reducing UAER in
  type 2 diabetes patients with microalbuminuria

Viberti et al, Circulation. 2002106672-678