BACKGROUND: The metabolic syndrome is associated with increased angiotensin II activity, induction of a proinflammatory and oxidative state, and endothelial dysfunction. We evaluated the ability of irbesartan, an angiotensin receptor blocker, and lipoic acid, an antioxidant, to affect endothelial function and inflammation in patients with the metabolic syndrome. METHODS AND RESULTS: We randomized 58 subjects with the metabolic syndrome in a double-blinded manner to irbesartan 150 mg/d (n=14), lipoic acid 300 mg/d (n=15), both irbesartan and lipoic acid (n=15), or matching placebo (n=14) for 4 weeks. Endothelium-dependent and -independent flow-mediated vasodilation was determined under standard conditions. Plasma levels of interleukin-6, plasminogen activator-1, and 8-isoprostane were measured. After 4 weeks of therapy, endothelium-dependent flow-mediated vasodilation of the brachial artery was increased by 67%, 44%, and 75% in the irbesartan, lipoic acid, and irbesartan plus lipoic acid groups, respectively, compared with the placebo group. Treatment with irbesartan and/or lipoic acid was associated with statistically significant reductions in plasma levels of interleukin-6 and plasminogen activator-1. In addition, treatment with irbesartan or irbesartan plus lipoic acid decreased 8-isoprostane levels. No significant changes in blood pressure were noted in any of the study groups. CONCLUSIONS: Administration of irbesartan and/or lipoic acid to patients with the metabolic syndrome improves endothelial function and reduces proinflammatory markers, factors that are implicated in the pathogenesis of atherosclerosis.
RCT Entities:
BACKGROUND: The metabolic syndrome is associated with increased angiotensin II activity, induction of a proinflammatory and oxidative state, and endothelial dysfunction. We evaluated the ability of irbesartan, an angiotensin receptor blocker, and lipoic acid, an antioxidant, to affect endothelial function and inflammation in patients with the metabolic syndrome. METHODS AND RESULTS: We randomized 58 subjects with the metabolic syndrome in a double-blinded manner to irbesartan 150 mg/d (n=14), lipoic acid 300 mg/d (n=15), both irbesartan and lipoic acid (n=15), or matching placebo (n=14) for 4 weeks. Endothelium-dependent and -independent flow-mediated vasodilation was determined under standard conditions. Plasma levels of interleukin-6, plasminogen activator-1, and 8-isoprostane were measured. After 4 weeks of therapy, endothelium-dependent flow-mediated vasodilation of the brachial artery was increased by 67%, 44%, and 75% in the irbesartan, lipoic acid, and irbesartan plus lipoic acid groups, respectively, compared with the placebo group. Treatment with irbesartan and/or lipoic acid was associated with statistically significant reductions in plasma levels of interleukin-6 and plasminogen activator-1. In addition, treatment with irbesartan or irbesartan plus lipoic acid decreased 8-isoprostane levels. No significant changes in blood pressure were noted in any of the study groups. CONCLUSIONS: Administration of irbesartan and/or lipoic acid to patients with the metabolic syndrome improves endothelial function and reduces proinflammatory markers, factors that are implicated in the pathogenesis of atherosclerosis.
Authors: Todd M Manini; Stephen D Anton; Daniel P Beavers; Jane A Cauley; Mark A Espeland; Roger A Fielding; Stephen B Kritchevsky; Christiaan Leeuwenburgh; Kristina H Lewis; Christine Liu; Mary M McDermott; Michael E Miller; Russell P Tracy; Jeremy D Walston; Barbara Radziszewska; Jane Lu; Cindy Stowe; Samuel Wu; Anne B Newman; Walter T Ambrosius; Marco Pahor Journal: J Am Geriatr Soc Date: 2017-07-22 Impact factor: 5.562
Authors: Naomi M Hamburg; Martin G Larson; Joseph A Vita; Ramachandran S Vasan; Michelle J Keyes; Michael E Widlansky; Caroline S Fox; Gary F Mitchell; Daniel Levy; James B Meigs; Emelia J Benjamin Journal: Am J Cardiol Date: 2008-01-01 Impact factor: 2.778
Authors: Gjumrakch Aliev; Jiankang Liu; Justin C Shenk; Kathryn Fischbach; Gerardo J Pacheco; Shu G Chen; Mark E Obrenovich; Walter F Ward; Arlan G Richardson; Mark A Smith; Eldar Gasimov; George Perry; Bruce N Ames Journal: J Cell Mol Med Date: 2008-03-28 Impact factor: 5.310