What question did this study set out to answer?

To determine whether angiotensin II receptor blockade with candesartan cilexetil improves resistance artery endothelial and smooth muscle function in patients with type 2 diabetes and hypertension.

January 4, 2005Hypertension

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

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Why the study?

Does candesartan cilexetil improve small artery endothelial function in patients with type 2 diabetes mellitus?

Population

Patients with type 2 diabetes mellitus

Comparison

Candesartan cilexetil for 12 weeks vs Placebo

Design

RCT, Randomized parallel group, Double-blind

Follow-up

12 weeks

Authors

RMRayaz A. MalikManchester Academic Health Science Centre ISIan J. SchofieldAstraZeneca (Sweden)AIAshley S. IzzardUniversity of Manchester

Discussion

Member takes

Implication

Candesartan may enhance endothelial function in T2DM; extends ARB vascular benefits to resistance vessels in diabetes.

Key Points

To determine whether angiotensin II receptor blockade with candesartan cilexetil improves resistance artery endothelial and smooth muscle function in patients with type 2 diabetes and hypertension.
Randomized, 12-week, double-blind, placebo-controlled parallel-group trial evaluating candesartan cilexetil in patients with type 2 diabetes and hypertension.
Resistance vessel function was assessed ex vivo using pressure myography to measure vascular responses to acetylcholine, sodium nitroprusside, norepinephrine, and angiotensin II.
Candesartan significantly improved impaired maximal dilatation to acetylcholine, driven predominantly by enhanced nitric oxide-mediated dilatation, with endothelial dysfunction correlating directly with serum LDL cholesterol levels.
Endothelium-independent dilatation to sodium nitroprusside showed improved sensitivity (EC50) without altering maximal response, while vasoconstriction to angiotensin II was reduced and norepinephrine responses remained unchanged.

Structured PICO

Does candesartan cilexetil improve small artery endothelial function in patients with type 2 diabetes mellitus?

Population

Patients with type 2 diabetes mellitus

Intervention

Candesartan cilexetil for 12 weeks

Comparator

Placebo

Outcome

Vessel function (maximal vascular response to acetylcholine) assessed by pressure myographysurrogate

Brief treatment with angiotensin II receptor blockade (candesartan) significantly improves resistance vessel endothelial function in patients with type 2 diabetes.

Cite This Study

Malik et al. (2005) studied this question.

synapsesocial.com/papers/6a88ec439f05dd9930a2a86e https://doi.org/10.1161/01.hyp.0000153305.50128.a1

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

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider