Comparison of the Effects of Ramipril Versus Telmisartan in Reducing Serum Levels of High-Sensitivity C-Reactive Protein and Oxidized Low-Density Lipoprotein Cholesterol in Patients With Type 2 Diabetes Mellitus

Koulouris, Spyridon; Symeonides, P.; Triantafyllou, Konstantinos; Ioannidis, G.; Karabinos, Ilias; Katostaras, Theofanis; El-Ali, Mahmud; Theodoridis, Theodoros; Vratsista, Ekaterini; Thalassinos, Nikolaos; Kokkinou, Vassiliki; Nanas, Ioannis; Stamatelopoulos, Stamatios; Toutouzas, Pavlos

doi:10.1016/j.amjcard.2005.01.092

Cited by 54 publications

(38 citation statements)

References 16 publications

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“…Currently this discrepancy can not be explained. Telmisartan, 40 mg daily for 3 months, reduced serum levels of CRP by 38% in patients with type II diabetes (67). Irbesartan (300 mg daily for three months) in patients with coronary artery disease significantly reduced plasma levels of CRP (by 2.8 mg/L) (125).…”

Section: Angiotensin II (Type 1) Receptor Blockersmentioning

confidence: 99%

“…Ramipril alone or in combination with telmisartan, an angiotensin II type I receptor blocker, significantly reduced the CRP in patients with type-2 diabetes (67,149) and patients with documented atherosclerosis (82). Ramipril reduced the levels of CRP by approximately 32% in atherosclerotic patients (82) and CRP by 24% in diabetic patients (67). In patients with myocardial infarction (137), and in atherosclerotic rabbits (92) quinapril reduced plasma CRP levels.…”

Section: Angiotensin Converting Enzyme (Ace) Inhibitorsmentioning

confidence: 99%

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C‐Reactive Protein (CRP)‐Lowering Agents

Prasad

2006

Cardiovascular Drug Reviews

237

185

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C-reactive protein (CRP) plays a role in the pathogenesis of cardiovascular disease. It is a marker and predictor of cardiovascular disease. CRP possesses numerous cardiovascular effects (clotting, generation of oxygen radicals, increase in the expression of adhesion molecules and plasminogen activator inhibitor-1, plaque destabilization) that could result in cardiovascular disease. This review describes the effects of various cardiovascular drugs on the levels of CRP in health and disease. Cyclooxygenase inhibitors (aspirin, rofecoxib, celecoxib), platelet aggregation inhibitors (clopidogrel, abciximab), lipid lowering agents (statins, ezetimibe, fenofibrate, niacin, diets), â-adrenoreceptor antagonists and antioxidants (vitamin E), as well as angiotensin converting enzyme (ACE) inhibitors (ramipril, captopril, fosinopril), reduce serum levels of CRP; while enalapril and trandolapril have not been shown to have the same effect. Angiotensin receptor blockers (ARBs) (valsartan, irbesartan, olmesartan, telmisartan) markedly reduce serum levels of CRP. The findings with other ARBs (losartan and candesartan) were inconsistent. Antidiabetic agents (rosiglitazone and pioglitazone) reduce CRP levels, while insulin is ineffective. Calcium channel antagonists have variable effects on CRP levels. Hydrochlorothiazide and oral estrogen do not affect CRP. The CRP-lowering effect of statins is more pronounced than their lipid lowering effect and is not dependent on their hypolipemic activity. The effect of atorvastatin on CRP seems to be dose-dependent. CRP-lowering effect of statins is likely to contribute to the favorable outcome of statin therapy. The data suggest that lipid lowering agents, ACE inhibitors, ARBs, antidiabetic agents, antiinflammatory and antiplatelet agents, vitamin E, and â-adrenoreceptor antagonists lower serum or plasma levels of CRP, while vitamin C, oral estrogen and hydrochlorothiazide do not affect CRP levels.

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Section: Angiotensin II (Type 1) Receptor Blockersmentioning

confidence: 99%

Section: Angiotensin Converting Enzyme (Ace) Inhibitorsmentioning

confidence: 99%

C‐Reactive Protein (CRP)‐Lowering Agents

Prasad

2006

Cardiovascular Drug Reviews

237

185

View full text Add to dashboard Cite

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“…Nonsignifi cant changes in hsCRP were reported with candesartan 42,47,60,63 including the CENTRO (CandEsartaN on aTherosclerotic Risk factors) trial, a multicenter, randomized, double blind comparison of candesartan and enalapril, an ACEI, in hypertensive, diabetic patients showing no effect of the ARB (but also enalapril) on hsCRP. 60 Similar discrepancies also characterized the effect of telmisartan 59,62,65,66,74,78 including the already commented VIVALDI trial. 77 Positive results were reported for irbesartan in two studies in coronary heart disease patients, 54,57 but their small sample size preludes generalization.…”

Section: The Effect Of Arbs On Circulating Infl Ammatory Indicesmentioning

confidence: 94%

The effect of angiotensin receptor blockers on C-reactive protein and other circulating inflammatory indices in man

Fiorentino

Cianchetti²,

Celi³

et al. 2009

VHRM

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Anti-infl ammatory properties may contribute to the pharmacological effects of angiotensin II receptor blockers (ARBs), a leading therapeutic class in the management of hypertension and related cardiovascular and renal diseases. That possibility, supported by consistent evidence from in-vitro and animal studies showing pro-infl ammatory properties of angiotensin II, has been evaluated clinically by measuring the effect of ARBs on C-reactive protein and other circulating indices of infl ammation (e-selectin, adhesion molecules, interleukin-6, tissue necrosis factor-alpha, monocyte chemoattractant protein-1) of potential clinical relevance, a body of evidence that this paper aims to review.

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“…comparing candesartan and lisinopril; however, in their results, CRP concentration increases in the candesartan group and decreases in patients using lisinopril, albeit this difference is not statistically significant. Koulouris et al 26 observe that both ramipril and telmisartan lead to a reduction in CRP, but there was no difference among these drugs. To our knowledge, the present study was the first one to show a greater reduction of CRP with ACEi, when compared to ARB.…”

Section: Discussionmentioning

confidence: 99%

“…We suppose that this finding may be related to our sample's higher baseline CRP values (0.48 and 0.31 mg/dL) than in other studies (from 0.13 to 0.30 mg/dL). [24][25][26] During clinical consultation, we tried to exclude other potential causes of an elevated CRP, such as infections and rheumatic diseases. In addition, we looked for use of salicylic acid and statins, which were the same between groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of benazepril and losartan on endothelial function and vascular stiffness in patients with Type 2 diabetes mellitus and hypertension: A randomized controlled trial

Gismondi

Oigman

Bedirian

et al. 2015

J Renin Angiotensin Aldosterone Syst

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Introduction: The purpose of this study was to compare the effects of benazepril and losartan on endothelial function and vascular stiffness, in patients with diabetes mellitus and hypertension. Materials and methods: We included hypertensive diabetic patients with an office systolic blood pressure (BP) ⩾ 130 mmHg and/or diastolic BP ⩾ 80 mmHg. Patients were rolled over to amlodipine for 6 weeks, then we performed C-reactive protein assays, BP measurement and vascular tests; next, patients were randomized to benazepril or losartan. The tests were repeated after 12 weeks. Results: We randomized 14 patients to benazepril and 16 to losartan. There were no differences in systolic (139 versus 134 mmHg, p = 0.618) and diastolic (82 versus 80 mmHg, p = 0.950) BP at the end of the study. C-reactive protein values were lower in the benazepril group (0.38 versus 0.42 mg/dl, p = 0.020). There was a slightly higher flow-mediated vasodilation (FMD) response in the benazepril group (45% increase, p = 0.057) than in the losartan group (19% increase, p = 0.132). Both central systolic BP (129 versus 123 mmHg, p = 0.934) and carotid-femoral pulse wave velocity (cfPWV) (8.5 versus 8.5 m/s, p = 0.280) were the same between groups. Conclusions: Hypertensive diabetic patients using benazepril had a greater reduction in C-reactive protein, and a slight improvement in FMD, than those taking losartan.

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Comparison of the Effects of Ramipril Versus Telmisartan in Reducing Serum Levels of High-Sensitivity C-Reactive Protein and Oxidized Low-Density Lipoprotein Cholesterol in Patients With Type 2 Diabetes Mellitus

Cited by 54 publications

References 16 publications

C‐Reactive Protein (CRP)‐Lowering Agents

C‐Reactive Protein (CRP)‐Lowering Agents

The effect of angiotensin receptor blockers on C-reactive protein and other circulating inflammatory indices in man

Comparison of benazepril and losartan on endothelial function and vascular stiffness in patients with Type 2 diabetes mellitus and hypertension: A randomized controlled trial

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