Effects of Angiotensin Type-1 Receptor Antagonism on Small Artery Function in Patients With Type 2 Diabetes Mellitus

Endothelial dysfunction has been demonstrated to occur in small arteries from patients with type 2 diabetes and hypertension. The effects of angiotensin II receptor blockade on vessel function were examined using pressure myography in a randomized 12-week double-blind placebo-controlled parallel gro...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2005-02, Vol.45 (2), p.264-269
Main Authors: Malik, Rayaz A, Schofield, Ian J, Izzard, Ashley, Austin, Clare, Bermann, Georgina, Heagerty, Anthony M
Format: Article
Language:English
Subjects:
Acetylcholine
Adult
Angiotensin II
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Antihypertensive agents
Arterial hypertension. Arterial hypotension
Arteries - drug effects
Arteries - physiopathology
Benzimidazoles - therapeutic use
Biological and medical sciences
Biphenyl Compounds - therapeutic use
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - physiopathology
Double-Blind Method
Female
Humans
Male
Medical sciences
Middle Aged
Nitroprusside
Pharmacology. Drug treatments
Tetrazoles - therapeutic use
Vasoconstriction - drug effects
Vasoconstrictor Agents
Vasodilation - drug effects
Vasodilator Agents
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Summary:Endothelial dysfunction has been demonstrated to occur in small arteries from patients with type 2 diabetes and hypertension. The effects of angiotensin II receptor blockade on vessel function were examined using pressure myography in a randomized 12-week double-blind placebo-controlled parallel group study using candesartan cilexitil. The maximal vascular response to acetylcholine (Ach) was impaired at baseline and improved with candesartan. This improvement was primarily caused by an effect in the nitric oxide component of Ach-mediated dilatation. The degree of endothelial dysfunction directly correlated with serum low-density lipoprotein cholesterol levels. Sodium nitroprusside-induced endothelium-independent dilatation was reduced in diabetic patients and intervention with candesartan lead to an improvement in EC50 with no change in maximal response. Vasoconstriction to norepinephrine was normal and did not change with intervention, but responses to angiotensin II were reduced after candesartan in diabetic patients. These results demonstrate that even brief treatment with angiotensin II receptor blockade is associated with a significant improvement in resistance vessel endothelial function.
ISSN:0194-911X
1524-4563
DOI:10.1161/01.HYP.0000153305.50128.a1