Effects of irbesartan and perindopril on forearm reactive hyperemia and inflammatory process, in normotensive patientswith coronary artery disease

Abstract

The suppression of angiotensin II production by angiotensin converting enzyme inhibitors (ACEi), reduces the stimulation of both angiotensin-II receptor subtypes (AT1 and AT2), whereas angiotensin receptors antagonists preferentially block AT1 and leave AT2 unopposed [ [1] Levy B.I. Can angiotensin II type 2 receptors have deleterious effects in cardiovascular disease? Implications for therapeutic blockade of the renin–angiotensin system. Circulation. 2004; 109: 8-13 Crossref PubMed Scopus (149) Google Scholar ]. Long-term administration of AT1 antagonists increases plasma angiotensin-II and thereby over-stimulates AT2. However, it is unclear whether the beneficial effects observed with AT1 arise from the fall in blood pressure or to activation of AT2[ [1] Levy B.I. Can angiotensin II type 2 receptors have deleterious effects in cardiovascular disease? Implications for therapeutic blockade of the renin–angiotensin system. Circulation. 2004; 109: 8-13 Crossref PubMed Scopus (149) Google Scholar ]. Both ACEi and AT1 antagonists have anti-inflammatory properties [ [2] Schieffer B. Bunte C. Witte J. et al. Comparative effects of AT1-antagonism and angiotensin-converting enzyme inhibition on markers of inflammation and platelet aggregation in patients with coronary artery disease. J Am Coll Cardiol. 2004; 44: 362 Abstract Full Text Full Text PDF PubMed Scopus (217) Google Scholar ], although data comparing their effects are still limited.