Academic Journal
Vascular Effects of ACE (Angiotensin-Converting Enzyme) Inhibitors and Statins in Adolescents With Type 1 Diabetes
| العنوان: | Vascular Effects of ACE (Angiotensin-Converting Enzyme) Inhibitors and Statins in Adolescents With Type 1 Diabetes |
|---|---|
| المؤلفون: | Chiesa, ST, Marcovecchio, ML, Benitez-Aguirre, P, Cameron, FJ, Craig, ME, Couper, JJ, Davis, EA, Dalton, RN, Daneman, D, Donaghue, KC, Jones, TW, Mahmud, FH, Marshall, SM, Neil, HAW, Dunger, DB, Deanfield, JE, Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDI, . |
| المصدر: | Hypertension , 76 (6) pp. 1734-1743. (2020) |
| سنة النشر: | 2020 |
| المجموعة: | University College London: UCL Discovery |
| مصطلحات موضوعية: | adolescent, arteries, diabetes, type 1, puberty, vascular diseases |
| الوصف: | An increased albumin-creatinine ratio within the normal range can identify adolescents at higher risk of developing adverse cardio-renal outcomes as they progress into adulthood. Utilizing a parallel randomized controlled trial and observational cohort study, we characterized the progression of vascular phenotypes throughout this important period and investigated the effect of ACE (angiotensin-converting enzyme) inhibitors and statins in high-risk adolescents. Endothelial function (flow-mediated dilation and reactive hyperemia index) and arterial stiffness (carotid-femoral pulse wave velocity) were assessed in 158 high-risk participants recruited to a randomized, double-blind placebo-controlled 2×2 factorial trial (randomized, placebo-controlled trial) of ACE inhibitors and/or statins in adolescents with type 1 diabetes (AdDIT [Adolescent Type 1 Diabetes cardio-renal Intervention Trial]). Identical measures were also assessed in 215 lower-risk individuals recruited to a parallel observational study. In the randomized, placebo-controlled trial, high-risk patients randomized to ACE inhibitors had improved flow-mediated dilation after 2 to 4 years of follow-up (mean [95% CI]: 6.6% [6.0-7.2] versus 5.3% [4.7-5.9]; P=0.005), whereas no effect was observed following statin use (6.2% [5.5-6.8] versus 5.8% [5.1-6.4]; P=0.358). In the observational study, patients classed as high-risk based on albumin-creatinine ratio showed evidence of endothelial dysfunction at the end of follow-up (flow-mediated dilation=4.8% [3.8-5.9] versus 6.3% [5.8-6.7] for high-risk versus low-risk groups; P=0.015). Neither reactive hyperemia index nor pulse wave velocity were affected by either treatment (P>0.05 for both), but both were found to increase over the duration of follow-up (0.07 [0.03-0.12]; P=0.001 and 0.5 m/s [0.4-0.6]; P<0.001 for reactive hyperemia index and pulse wave velocity, respectively). ACE inhibitors improve endothelial function in high-risk adolescents as they transition through puberty. The longer-term protective ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| Relation: | https://discovery.ucl.ac.uk/id/eprint/10115303/1/Chiesa_Vascular%20Effects%20of%20ACE%20%28Angiotensin-Converting%20Enzyme%29%20Inhibitors%20and%20Statins%20in%20Adolescents%20With%20Type%201%20Diabetes_AAM.pdf; https://discovery.ucl.ac.uk/id/eprint/10115303/ |
| الاتاحة: | https://discovery.ucl.ac.uk/id/eprint/10115303/1/Chiesa_Vascular%20Effects%20of%20ACE%20%28Angiotensin-Converting%20Enzyme%29%20Inhibitors%20and%20Statins%20in%20Adolescents%20With%20Type%201%20Diabetes_AAM.pdf https://discovery.ucl.ac.uk/id/eprint/10115303/ |
| Rights: | open |
| رقم الانضمام: | edsbas.470526F |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |