- Randomized, Open Label, Multicenter Clinical Trial about the Effect of Cilazapril on Vascular Endothelial Function in Patients with Type 2 Diabetes Combined with Hypertension.
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Sang Youl Rhee, Jeong Taek Woo, Sei Hyun Baik, Hyoung Woo Lee, In Kyu Lee, Hye Soon Kim, Moon Kyu Lee, Min Ho Shong, Chung Gu Cho, Byoung Hyun Park, Bong Soo Cha, Young Seol Kim
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Korean Diabetes J. 2006;30(6):450-458. Published online November 1, 2006
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DOI: https://doi.org/10.4093/jkda.2006.30.6.450
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- BACKGROUND
The angiotensin converting enzyme inhibitor (ACEi) improves the vascular endothelial cell function and has a better clinical outcome by decreasing the LDL cholesterol oxidation, hypercoagulability, oxidative stress and improving the level of endothelial nitric oxide synthesis in patients with type 2 diabetes and hypertension. However, the correlations between the ACEi and the serum markers for the vascular endothelial function in previous studies were not consistent. SUBJECTS AND METHODS: Between July 2003 and April 2005, 104 type 2 diabetes patients with hypertension, who had been admitted to 9 major university hospitals in Korea, were examined. The subjects were randomly allocated to the cilazapril (2.5~5 mg/day) and atenolol (50~100 mg/day) treatment group and given a combination of hydrochlorothiazide and amlodipine. The lipid profile and the markers for endothelial function, such as vWF, VCAM, E-selectin, tPA, fibrinogen, adiponectin, hsCRP, nitrotyrosine were evaluated and the differences in the variables were compared with those obtained 6 months later. RESULTS: A total 56 subjects completed the 6-months follow up period. Regarding the baseline characteristics, there were no significant differences in the variables observed in the two groups except for HbA1c (P = 0.037), vWF (P = 0.048), and hsCRP (P = 0.038). After 6 months, both groups showed a significant and identical decrease in the systolic and diastolic blood pressure compared with the baseline (P < 0.002). However, there were no significant differences in the endothelial markers between each group. On the other hand, there was some deterioration in the triglyceride (P = 0.009) and HbA1c (P = 0.017) levels in the atenolol treatment groups. CONCLUSIONS: There were no significant differences in the endothelial function markers observed between the cilazapril and atenolol groups. However, cilazapril had an identical effect on the blood pressure reduction compared with atenolol but had fewer adverse effects on the glucose and lipid metabolism.
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Citations
Citations to this article as recorded by  - Potential Protective Role of Blood Pressure-Lowering Drugs on the Balance between Hemostasis and Fibrinolysis in Hypertensive Patients at Rest and During Exercise
Annabella Braschi
American Journal of Cardiovascular Drugs.2019; 19(2): 133. CrossRef
- Clinical and Coronary Angiographic Findings of Coronary Artery Disease in Patients with Noninsulin Dependent Diabetes Mellitus.
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Bon Jeong Ku, Bong Soo An, Jin Ok Jeong, In Whan Seong, Eun Seok Jeon, Min Ho Shong, Heung Kyu Ro, Young Kun Kim
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Korean Diabetes J. 1997;21(3):308-313. Published online January 1, 2001
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Abstract
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- BACKGROUND
Diabetes mellitus has a major impact on cardiac morbidity and mortality. We analyzed the clinical characteristics and coronary angiographic findings in patients with a coronary artery disease and with noninsulin dependent diabetes mellitus. METHODS: We retrospectively reviewed the clinical and coronary angiographic findings in 74 patients with noninsulin dependent cliabetes mellitus and in 328 non-diabetic patients who had a coronary insufficiency. RESULTS: Significant coronary occlusions and multiple coronary artery diseases were more common in diabetics than in non-diabetics. The patients with noninsulin dependent diabetes mellitus has several limiting factors to perform the successful percutaneous coronary angioplasty, it could be a possible factor for rapid deterioration of coronary insufficiency in patients with diabetes mellitus. Smoking and hypertension significantly increased the incidence of signiftcant coronary occlusions whereas obesity and hypercholesterolemia did not any significant influence on incidence of the significant coronary occlusions. The longer duration of diabetes rnellitus associated with higher incidence of significant coronary occlusions and multiple coronary diseases. CONCLUSION: Significant coronary occlusions and multiple coronary artery diseases were occurred more common in diabetics than in non-diabetics. Coronary angiography should be performed routinely in noninsulin dependent diabetes.
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