Question

The patient has diabetes mellitus and macroalbuminuria. The patient asks you why the physician is prescribing the angiotensin-converting enzyme (ACE) inhibitor lisinopril (Zestril) for him even though his blood pressure is well-controlled. What is your response?

A. It helps prevent hypertension as diabetics are prone to it.
B. ACE inhibitors delay the progression of nephropathy in patients with diabetes.
C. ACE inhibitors prevent macrovascular complications.
D. ACE inhibitors help prevent atherosclerosis.

Answer 1

ACE inhibitors like lisinopril are prescribed to diabetic patients with macroalbuminuria to delay the progression of nephropathy, even if blood pressure is currently well-controlled.

Step-by-step explanation:

The patient with diabetes mellitus and macroalbuminuria is being prescribed an angiotensin-converting enzyme (ACE) inhibitor, such as lisinopril (Zestril), not only for blood pressure control but also for its renal protective effects. Although this patient's blood pressure is well-controlled, ACE inhibitors delay the progression of nephropathy in patients with diabetes by reducing pressure in the glomeruli of the kidneys. This effect is achieved through the medication's ability to prevent the conversion of angiotensin I into angiotensin II, a substance that not only raises blood pressure systemically but also increases pressure within the kidneys, therefore aiding in preserving kidney function.