Last updated August 29, 2026
Key finding
Estimated acceleration factor was 1.665 (95% CI: 1.007 to 2.746, P = 0.047)
This study evaluated the effectiveness of combination therapy with benazepril and valsartan versus monotherapies in preventing microalbuminuria in type 2 diabetes patients.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Extended (5–20+ y)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the effectiveness of combination therapy with benazepril and valsartan versus monotherapies in preventing microalbuminuria in type 2 diabetes patients.
Preventing microalbuminuria is crucial in managing type 2 diabetes, as it can lead to more severe kidney issues. Understanding which treatment is more effective can help clinicians optimize care for diabetic patients, potentially improving long-term health outcomes.
The study's sample size may limit the generalizability of the findings. The effects of long-term treatment were not assessed. Potential confounding factors were not fully explored.
Published in
Publication details and source links for this paper.
Piero R, Monica C, Aneliya P, et al. Combination Therapy with Benazepril and Valsartan for Prevention of Microalbuminuria in Type 2 Diabetes: A Randomized Trial. PLOS Medicine. 2021;18(7):e1003691. doi:10.1371/journal.pmed.1003691
Valsartan showed a significant reduction in the time to progression to microalbuminuria compared to combination therapy (acceleration factor 1.665, P = 0.047).
Benazepril monotherapy did not show a significant difference in time to progression compared to either valsartan or combination therapy.
Combination therapy had a slight excess of hyperkalemia and hypotension compared to monotherapies.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Benazepril monotherapy, Combination therapy with benazepril and valsartan, Valsartan monotherapy and Time to progression to microalbuminuria, Incidence of hyperkalemia, Incidence of hypotension in patients on combination therapy.
This study contributes evidence to
Primary intervention
Benazepril monotherapy
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
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Related topics
5
Evidence pairs
0
Related studies
Core evidence
The primary outcomes reported in this study.
Benazepril monotherapy → Time to progression to microalbuminuria
Benazepril monotherapy → Time to progression to microalbuminuria
Combination therapy with benazepril and valsartan → Incidence of hyperkalemia
Combination therapy with benazepril and valsartan → Incidence of hyperkalemia
Combination therapy with benazepril and valsartan → Incidence of hypotension in patients on combination therapy
Combination therapy with benazepril and valsartan → Incidence of hypotension in patients on combination therapy
Combination therapy with benazepril and valsartan → Time to progression to microalbuminuria
Combination therapy with benazepril and valsartan → Time to progression to microalbuminuria
Valsartan monotherapy → Time to progression to microalbuminuria
Valsartan monotherapy → Time to progression to microalbuminuria
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Benazepril monotherapy and Time to progression to microalbuminuria, Combination therapy with benazepril and valsartan and Incidence of hypotension in patients on combination therapy.
This study contributes to the evidence on the following intervention-outcome relationships.
Curated evidence collections and hubs this study is part of.
All studies on Benazepril monotherapy
Contributes to Benazepril monotherapy evidence base.
All studies on Combination therapy with benazepril and valsartan
Contributes to Combination therapy with benazepril and valsartan evidence base.
All studies measuring Incidence of hypotension in patients on combination therapy
Measures Incidence of hypotension in patients on combination therapy as a key outcome.
All studies measuring Time to progression to microalbuminuria
Measures Time to progression to microalbuminuria as a key outcome.
Jump to pre-filtered views in Evidence Explorer.
1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Current evidence does not show a clear benefit of Benazepril monotherapy for time to progression to microalbuminuria.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Time to progression to microalbuminuria
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear reduction in incidence of hyperkalemia with Combination therapy with benazepril and valsartan.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Incidence of hyperkalemia
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear reduction in incidence of hypotension in patients on combination therapy with Combination therapy with benazepril and valsartan.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Incidence of hypotension in patients on combination therapy
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Combination therapy with benazepril and valsartan for time to progression to microalbuminuria.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Time to progression to microalbuminuria
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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