In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 7 ( 2001-07), p. 1539-1545
Abstract:
Background and Purpose —Whether angiotensin-converting enzyme (ACE) inhibitors have any clinically significant antiatherogenic effects in humans remains unproven. We undertook a prospective randomized clinical trial of 98 patients with non–insulin-dependent diabetes mellitus (NIDDM) to examine the efficacy of ACE inhibition with enalapril for preventing intima-media (IM) thickening of the carotid wall as measured ultrasonographically. Methods —Ninety-eight NIDDM patients were randomly assigned either to enalapril at 10 mg/d (n=48) or to a control group (n=50); the planned duration of the trial was 2 years. All patients were seen at baseline (study entry) and 2 subsequent formal annual evaluations, in addition to standard clinical management for NIDDM. IM thickening and vascular lumen diameters were determined for all patients on the basis of baseline and 2 subsequent annual evaluations with carotid ultrasonography. We performed an intent-to-treat analysis to assess changes in IM thickening over the course of the study. Results —Annual IM thickening measurements of the right and left common carotid arteries were 0.01±0.02 and 0.01±0.02 mm/y in the enalapril-treated group and 0.02±0.03 and 0.02±0.02 mm/y in the control group, respectively ( P 〈 0.05). From regression analysis, annual IM thickening was found to be predicted by enalapril use, sex, and insulin use (F 3,94 =3.86, P =0.012). When we controlled for these other variables, enalapril use reduced annual IM thickening of right and left common carotid arteries by 0.01±0.004 mm/y relative to the control group over the course of this study. Conclusions —Long-term treatment with an ACE inhibitor (enalapril) slows progressive IM thickening of the common carotid artery in NIDDM patients.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/01.STR.32.7.1539
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2001
detail.hit.zdb_id:
80381-9
detail.hit.zdb_id:
1467823-8
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