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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

Spyridon Koulouris, MD, PhD, Phivos Symeonides, MD, Konstantinos Triantafyllou, MD, Georgios Ioannidis, MD, Ilias Karabinos, MD, Theofanis Katostaras, PhD, Mahmud El-Ali, MD, Theodoros Theodoridis, MD, Ekaterini Vratsista, MD, Nikolaos Thalassinos, MD, Vassiliki Kokkinou, MD, Ioannis Nanas, MD, PhD, Stamatios Stamatelopoulos, MD, PhD, and Pavlos Toutouzas, MD, PhD  

The effect of ramipril (an angiotensin [AT]-converting enzyme inhibitor), telmisartan (an AT-II type 1 receptor blocker), or their combination on inflammation and lipid peroxidation was assessed in 37 patients with type 2 diabetes who were free of coronary artery disease. All regimens were associated with a significant reduction of C-reactive protein and oxidized low-density lipoprotein cholesterol serum levels (p <0.001). These results further enlighten the mechanisms underlying the cardiovascular beneficial effect of renin-AT system inhibition. _2005 by Excerpta Medica Inc. (Am J Cardiol 2005;95:1386-1388)  

Agents that inhibit the renin-angiotensin (AT) system (RAS), such as AT-converting enzyme (ACE) inhibitors and AT-II type 1 receptor blockers, have a well-established beneficial role in the treatment of patents with diabetes, hypertension, and congestive heart failure.1-3 Moreover, because several studies have shown that AT-II has a high level of atherogenic potency by promoting vasoconstriction, inflammation, oxidative stress, thrombosis, and plaque rupture,4-6 a potential antiatherogenic effect of RAS inhibition has been implicated.7,8 However, direct comparisons between these 2 drug categories regarding their biologic or clinical effects against atherosclerosis have been scarce. Thus, we conducted a clinical trial to assess and compare the antioxidant and anti-inflammatory effects of ramipril (an ACE inhibitor) and telmisartan (an AT-II type 1 receptor blocker) in a group of diabetic patients without overt atherosclerosis.  

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