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©2013 UpToDate ® Print Email Antihypertensive drugs and urinary protein excretion in diabetic nephropathy Protein excretion at baseline (black columns) and after one year of antihypertensive therapy (hatched columns) in patients with type 2 diabetes treated with lisinopril (mean dose 29 mg/day), verapamil (mean dose 360 mg/day), half-dose lisinopril plus verapamil, or hydrochlorothiazide plus guanfacine (which has a mechanism of action similar to methyldopa). The last regimen had little or no antiproteinuric effect while the fall in protein excretion with the lisinopril-verapamil combination (75 percent) was additive to the action of either drug alone (roughly 50 percent). Data from: Bakris GL, Barnhill BW, Sadler R. Kidney Int 1992; 41:912.