A Randomised Controlled Trial of Medical Prophylaxis for the Prevention of Hypertension, Renal Disease and Diabetes in Australian Aborigines

INTERVENTION: Oral once daily dosage of Coversyl (Perindopril), a long acting angiotensin converting enzyme inhibitor(ACEi) Masked participants will be commenced on 5mg of Coversyl (Perindopril) oral daliy for four weeks, then titrated to the full oral daily dose of 10mg Coversyl (Perindopril) where tolerated. Participants are requested to participate in the study for up to 5 years from there date of enrollment. CONDITION: Diabetes Hypertension Renal Disease PRIMARY OUTCOME: Blood Pressure (BP) greater than 140/90 Diagnosis of Diabetes as per World Health Organizations guidelines‐ Two Hour Oral Glucose Tolerance Urine‐ Albumin Creatinine Ratio (ACR) greater than 3.4 gm/mol SECONDARY OUTCOME: Body composition changes‐Measured by changes in: ; Weight in kilograms ; Waist in centimeters (measured to the nearest 0.2 cm) Cardiovascular events‐ measured by attendance at remote area health services or hospitalization data Natural deaths‐ data collected from, remote area health services and office of births, deaths and marriages INCLUSION CRITERIA: Consenting Tiwi Aboriginal adults age 18+ years BP less then or equal to 140/90 Urine albumin creatinine ratio less then 3.4 gm/mol Without diabetes Who are without contraindications to ACEi.