Angiotensin-converting enzyme inhibition improves vascular function in rheumatoid arthritis.

Détails

ID Serval
serval:BIB_8F0B109D6ACB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Angiotensin-converting enzyme inhibition improves vascular function in rheumatoid arthritis.
Périodique
Circulation
Auteur(s)
Flammer A.J., Sudano I., Hermann F., Gay S., Forster A., Neidhart M., Künzler P., Enseleit F., Périat D., Hermann M., Nussberger J., Luscher T.F., Corti R., Noll G., Ruschitzka F.
ISSN
1524-4539[electronic]
Statut éditorial
Publié
Date de publication
2008
Volume
117
Numéro
17
Pages
2262-2269
Langue
anglais
Résumé
BACKGROUND: The excess in cardiovascular risk in patients with rheumatoid arthritis provides a strong rationale for early therapeutical interventions. In view of the similarities between atherosclerosis and rheumatoid arthritis and the proven benefit of angiotensin-converting enzyme inhibitors in atherosclerotic vascular disease, it was the aim of the present study to delineate the impact of ramipril on endothelial function as well as on markers of inflammation and oxidative stress in patients with rheumatoid arthritis. METHODS AND RESULTS: Eleven patients with rheumatoid arthritis were included in this randomized, double-blind, crossover study to receive ramipril in an uptitration design (2.5 to 10 mg) for 8 weeks followed by placebo, or vice versa, on top of standard antiinflammatory therapy. Endothelial function assessed by flow-mediated dilation of the brachial artery, markers of inflammation and oxidative stress, and disease activity were investigated at baseline and after each treatment period. Endothelial function assessed by flow-mediated dilation increased from 2.85+/-1.49% to 4.00+/-1.81% (P=0.017) after 8 weeks of therapy with ramipril but did not change with placebo (from 2.85+/-1.49% to 2.84+/-2.47%; P=0.88). Although systolic blood pressure and heart rate remained unaltered, diastolic blood pressure decreased slightly from 78+/-7 to 74+/-6 mm Hg (P=0.03). Tumor necrosis factor-alpha showed a significant inverse correlation with flow-mediated dilation (r=-0.408, P=0.02), and CD40 significantly decreased after ramipril therapy (P=0.049). CONCLUSIONS: Angiotensin-converting enzyme inhibition with 10 mg/d ramipril for 8 weeks on top of current antiinflammatory treatment markedly improved endothelial function in patients with rheumatoid arthritis. This finding suggests that angiotensin-converting enzyme inhibition may provide a novel strategy to prevent cardiovascular events in these patients.
Mots-clé
Adult, Aged, Angiotensin-Converting Enzyme Inhibitors, Arthritis, Rheumatoid, Atherosclerosis, Biological Markers, Cells, Cultured, Cross-Over Studies, Endothelial Cells, Female, Humans, Male, Middle Aged, Oligonucleotide Array Sequence Analysis, Oxidative Stress, Ramipril, Renin-Angiotensin System, Risk Factors, Treatment Outcome, Umbilical Veins, Vasculitis, Vasodilation
Pubmed
Web of science
Open Access
Oui
Création de la notice
02/04/2009 15:45
Dernière modification de la notice
08/05/2019 21:54
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