ramipril and Hyperlipidemias

In a randomized, double-blind, placebo-controlled study, we investigated in normotensive type 2 diabetics with microalbuminuria the effect of ramipril, an ACE inhibitor, on urine albumin excretion and serum lipids. A total of 1,882 patients were screened for urine microalbumin consecutively by dipstick test, Rapi Tex-Albumin test and RIA. The final 28 normotensive and microalbuminuric patients were assigned to receive either ramipril (1.25 mg/d, n = 16) or placebo (n = 12) for 12 weeks. Throughout the study, both groups had no changes in blood pressure, fasting plasma glucose, HbA1C, serum creatinine and electrolytes and no difference in creatinine clearance. At week 12 only the placebo group showed the significant increment of urine albumin excretion and triacylglycerol (30.6 +/- 38.3 to 39.0 +/- 19.7 and 167 +/- 64 to 208 +/- 77 mg/dl, respectively) but the decrement of HDL-cholesterol (46 +/- 16 to 35 +/- 6 mg/dl). During a 3 month period, increased urine albumin excretion was observed in normotensive type 2 diabetes with microalbuminuria who received only placebo. We conclude that ramipril may arrest the progression of albumin excretion and had favorable effects on serum lipids. Ramipril was safe and well-tolerated without untoward side effects during the study period.

Topics: Albuminuria; Angiotensin-Converting Enzyme Inhibitors; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Double-Blind Method; Humans; Hyperlipidemias; Ramipril

In a randomized, double-blind, placebo-controlled study, we investigated in normotensive type 2 diabetics with microalbuminuria the effect of ramipril, an ACE inhibitor, on urine albumin excretion and serum lipids. A total of 1,882 patients were screened for urine microalbumin consecutively by dipstick test, Rapi Tex-Albumin test and RIA. The final 28 normotensive and microalbuminuric patients were assigned to receive either ramipril (1.25 mg/d, n = 16) or placebo (n = 12) for 12 weeks. Throughout the study, both groups had no changes in blood pressure, fasting plasma glucose, HbA1C, serum creatinine and electrolytes and no difference in creatinine clearance. At week 12 only the placebo group showed the significant increment of urine albumin excretion and triacylglycerol (30.6 +/- 38.3 to 39.0 +/- 19.7 and 167 +/- 64 to 208 +/- 77 mg/dl, respectively) but the decrement of HDL-cholesterol (46 +/- 16 to 35 +/- 6 mg/dl). During a 3 month period, increased urine albumin excretion was observed in normotensive type 2 diabetes with microalbuminuria who received only placebo. We conclude that ramipril may arrest the progression of albumin excretion and had favorable effects on serum lipids. Ramipril was safe and well-tolerated without untoward side effects during the study period.

Topics: Albuminuria; Angiotensin-Converting Enzyme Inhibitors; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Double-Blind Method; Humans; Hyperlipidemias; Ramipril

Treatment with C. mukul and O. sanctum, showed a significant decrease in cholesterol and triglyceride levels respectively. O. sanctum also significantly increased serum HDL-cholesterol compared to control. Serum MDA levels were significantly reduced in all the treated groups compared to control suggesting that each of the drugs under study were effective in their free radical scavenging action. Erythrocyte SOD activity was increased in all the treatment groups with C. mukul showing the maximum effect followed by O. sanctum, folic acid and ramipril. The erythrocyte CAT activity was significantly increased in all the drug treated groups with maximum increase seen in O. sanctum and ramipril treated groups, whereas lesser effects were observed with C. mukul and folic acid groups. Thus, the indigenous drugs, C. mukul and O. sanctum had beneficial effect on hypercholesterolemic rabbit model, both in terms of lipid profile as well as antioxidant potential. Ocimum sanctum was found to be the most promising of all the drugs. Moreover, it could be hypothesized that these plant products along with folic acid and ramipril can be explored for synergistic effect for treatment for hypercholesterolemic conditions.

Topics: Angiotensin-Converting Enzyme Inhibitors; Animals; Catalase; Cholesterol, Dietary; Cholesterol, HDL; Commiphora; Erythrocytes; Folic Acid; Hyperlipidemias; Lipid Peroxidation; Male; Malondialdehyde; Molecular Structure; Ocimum; Phytotherapy; Plant Extracts; Rabbits; Ramipril; Superoxide Dismutase; Time Factors; Triglycerides; Vitamin B Complex

The contribution of nondegraded bradykinin to the metabolic effects of the angiotensin-converting enzyme (ACE)-kininase II inhibitor ramipril was evaluated in rats rendered hypertensive, hyperinsulinemic, and hypertriglyceridemic by a fructose-enriched diet. The response of blood pressure, insulin, and triglyceride levels to concomitant administration of ramipril and the bradykinin antagonist HOE 140 was studied. Rats that received ramipril, HOE 140, or not treated at all served as controls. Treatment with ramipril reduced levels of both insulin (from 6.6 +/- 2.0 to 3.6 +/- 1.7 ng/ml; p < 0.05) and triglycerides (from 292 +/- 88 to 164 +/- 35 mg/dl; p < 0.001) as well as blood pressure (from 144 +/- 6 to 116 +/- 6 mm Hg; p < 0.001). In contrast, treatment with HOE 140 did not alter any of these parameters. The combined treatment, however, blunted the beneficial metabolic effects of ramipril on insulin (7.8 +/- 4.4 ng/ml before and 7.7 +/- 2.9 ng/ml after treatment) and triglycerides (290 +/- 135 mg/dl before and 285 +/- 152 mg/dl after treatment), whereas the hypotensive effect of ramipril was preserved (151 +/- 8 mm Hg before and 122 +/- 6 mm Hg after treatment (p < 0.001). The data suggest that whereas the hypotensive effect is mostly angiotensin-II dependent, the advantageous metabolic affect of ramipril is highly dependent on the accumulation of bradykinin.

Topics: Adrenergic beta-Antagonists; Angiotensin-Converting Enzyme Inhibitors; Animals; Antihypertensive Agents; Blood Pressure; Bradykinin; Fructose; Hyperinsulinism; Hyperlipidemias; Hypertension; Insulin; Male; Ramipril; Rats; Rats, Sprague-Dawley; Triglycerides

Endothelium-dependent relaxation in arteries is attenuated in clinical and experimental atherosclerosis. This study investigates the endothelial preservation properties of the angiotensin converting enzyme inhibitor, ramipril, by assessing its ability to restore endothelium-dependent responsiveness in blood vessels from rabbits fed an atherogenic diet (0.25% cholesterol; 3% coconut oil; 12 weeks). Seven rabbits fed the atherogenic diet received ramipril (3 mg/kg mixed into their food daily) and 6 rabbits were maintained on the atherogenic diet alone. Control rabbits (n = 6) were fed a standard diet and did not receive ramipril. At the end of the dietary intervention, the rabbits were killed and blood was collected for measurement of the lipid profile. The thoracic aorta was isolated and half was frozen for pathologic review while the other half was cut into rings and placed in a muscle bath for measurement of isometric force development. Dose response curves to phenylephrine (10(-9) to 10(-5) M) and angiotensin II (10(-10) to 3 x 10(-7) M) were completed. There was a minimal decrease in responsiveness to phenylephrine in vessels from rabbits eating the atherogenic diet compared with controls and no significant differences in the response to angiotensin II for any of the vessels. Following contraction by phenylephrine, acetylcholine (10(-9) to 10(-5) M) and nitroglycerin (10(-10) to 10(-5) M) dose response curves were completed. Relaxation to acetylcholine in aortic rings from control rabbits was observed, although in arteries from atherogenic rabbits relaxation was attenuated. This effect was prevented in the atherogenic rabbits fed ramipril. Responsiveness to the endothelium-independent vasodilator, nitroglycerin, was similar in arteries from the three rabbit groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acetylcholine; Angiotensin II; Animals; Aorta, Thoracic; Cholesterol; Diet, Atherogenic; Dose-Response Relationship, Drug; Endothelium, Vascular; Hyperlipidemias; In Vitro Techniques; Male; Nitroglycerin; Phenylephrine; Rabbits; Ramipril; Vasodilation