[Effects of angiotensin receptor blocker and angiotensin-coverting enzyme inhibitor on vascular endothelial function in type 2 diabetic patients with atherosclerosis: a comparative study].
OBJECTIVE
To compare the changes of endothelial function in type 2 diabetic patients with atherosclerosis (AS) after treatment with angiotensin-coverting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB).


METHODS
Totally 145 type 2 diabetic patients with AS were included in this study. According to completely randomized open unbalanced design, the patients were assigned into ACEI group (n=99) with ramipril treatment (starting dose of 2.5 mg/d and gradually reaching 5 mg/d), ARB group (n=25) with irbesartan treatment (with gradual increase of doses till reaching the maximum daily dose of 150 mg), and control group (n=21) without the above medication. After a treatment lasting for 3 months, the brachial artery endothelial function was evaluated with two-dimensional ultrasonography.


CONCLUSIONS
After therapy, endothelium-dependent vasodilation (EDV) of the brachial artery increased from (3.55+/-2.80)% to (5.62+/-4.18)% (P=0.001), and endothelium-independent vasodilation (EIV) increased from (12.62+/-7.48)% to (12.80+/-7.04)% (P=0.835) in ACEI group. EDV increased from (4.42+/-2.95) % to (6.28+/-3.26)% (P=0.039), while EIV decreased from (10.69+/-5.85)% to (9.54+/-4.78)% (P=0.229) in ARB group. No statistical changes in the indices were found after therapy in the control group (P>0.05). Comparison of endothelial function in the 3 groups showed no statistical significance in the changes of EDV between ACEI and ARB groups (P=0.853). No differences were found in the change of EIV in the 3 groups (P=0.644). The therapy with 150 mg irbesartan and 5 mg ramipril for 3 months produces similar effects on the endothelial function in these patients.
Wang
Ling
L
Institute of Cardiovascular Disease of Guangdong Province, Guangzhou 510100, China. doctorwangling@21cn.com
Huang
Xin-sheng
XS
Zhou
Ying-ling
YL
Chen
Ji-yan
JY
Lin
Shu-guang
SG
D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000150:complications / Q000188:drug therapy*; D001713:Biphenyl Compounds / Q000627:therapeutic use; D001916:Brachial Artery / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D000077405:Irbesartan; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000627:therapeutic use; D013777:Tetrazoles / Q000627:therapeutic use
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D001713:Biphenyl Compounds; D013777:Tetrazoles; D000077405:Irbesartan; D017257:Ramipril