title: Effect of rosiglitazone and ramipril on macrovasculopathy in patients with type 2 diabetes: needs longer treatment and/or higher doses?
abstract: BACKGROUND
  The aim of the study is to investigate whether standard doses of rosiglitazone (4 mg/daily) and ramipril (5 mg/daily) can reverse pre-clinical macrovasculopathy in newly diagnosed never treated type 2 diabetes (T2DM) patients.
  
  
  METHODS
  In this randomized, double-blind, placebo-controlled study, 33 T2DM patients were randomized to rosiglitazone (4 mg/daily) or ramipril (5 mg/daily) or placebo for 1 year. Hemodynamic variables were measured at 3 treatment phases and pulse wave velocity (PWV) and augmentation index (AI) were measured throughout the treatment period.
  
  
  RESULTS
  In diabetic patients, PWV (P = 0.037) and AI (P = 0.005) with ramipril and AI (P < 0.001) with rosiglitazone were significantly reduced during overall treatment period from the baseline; however, these differences were not significant in comparison to placebo.
  
  
  CONCLUSIONS
  The present study showed that treatment with standard doses of rosiglitazone and ramipril are not adequate to reverse pre-clinical vasculopathy in T2DM. The lack of benefit in newly diagnosed T2DM may be because of the relatively short-term intervention and/or the use of lower doses of rosiglitazone/ramipril. Further trials are needed for a longer period of time, possibly with higher doses, to show whether rosiglitazone/ramipril can reverse pre-clinical vasculopathy in T2DM (ClinicalTrials.gov number, NCT00489229).
authors.affiliation: Department of Clinical Sciences, School of Life Sciences, University of Bradford, Bradford, UK. srahman6@bradford.ac.uk, seempi2005@yahoo.co.uk
authors.forename: Sayeeda
authors.initials: S
authors.lastname: Rahman
authors.forename: Aziz Al-Shafi
authors.initials: AA
authors.lastname: Ismail
authors.forename: Shaiful Bhari
authors.initials: SB
authors.lastname: Ismail
authors.forename: Nyi Nyi
authors.initials: NN
authors.lastname: Naing
authors.forename: Abdul Rashid Abdul
authors.initials: AR
authors.lastname: Rahman