Physiological and Biochemical Analysis of Coffea arabica Cultivars in the Early Stage of Development Subjected to Water Stress for the Selection of Cultivars Adapted to Drought

Responses of grapevine vegetative growth components to mild, medium and severe soil water deficits were used to identify simple and sensitive indicators for early diagnosis of water stress. Soil water deficit was characterised as the fraction of transpirable soil water (FTSW) remaining in a water-depleted rootzone. Growth components included the number of emerged leaves on first (Ist) and second (IInd) order lateral branches, the leaf area and internode length of each phytomer of Ist order lateral branches, and the frequency of IInd order lateral branching. These components were measured in a greenhouse on Shiraz (syn. Syrah) grapevines, over a 38-day period of stabilised soil water regimes. Leaf emergence rate, final leaf area and final internode length of lateral branches I were relatively insensitive to mild and medium water deficits. They only decreased in response to severe water deficits. The frequency of IInd order lateral branching showed a similar trend, but was inhibited at severe water deficits. The leaf emergence rate of lateral branches II was highly sensitive to FTSW, and decreased even in response to mild water deficits. Because measurement of leaf emergence rate is a time consuming process, further analysis of the data was undertaken to identify a simpler but similarly effective indicator of cumulative water deficit. Accordingly, we established that the final length of lateral branches I was sensitive to medium water deficits, while the final ratio of the number of leaves on lateral branches II to the number of leaves on lateral branches I, was sensitive to even mild water deficits. Both of these composite indicators (derived variables) were relatively easy to measure and showed potential as early indicators of water deficits. They were more sensitive to FTSW than was predawn leaf water potential. Moreover, the final ratio of the number of leaves on lateral branches II to the number of leaves on lateral branches I was even more sensitive to FTSW than was stomatal conductance.

Long-term studies of tree responses to drought stress help us to understand the capacity of species to adapt to their environment. In this study, we investigated how Eucalyptus obliqua adjusts physiological and morphological traits in response to seasonal and multi-year droughts. We monitored physiological and morphological traits over multiple years in undisturbed control and throughfall reduction plots in a eucalypt forest in south-eastern Australia. The throughfall reduction treatment did not induce significantly lower soil moisture in the throughfall reduction plots compared with the control plots. However, natural variability in precipitation and evaporative demand induced drought stress of varying intensity each summer in all plots. We observed a significant relationship between seasonal precipitation and leaf pre-dawn water potential (ΨPD), with less precipitation over summer, resulting in a decline in ΨPD and drought stress when ΨPD fell below −0.75 MPa. Eucalyptus obliqua responded to short-term summer drought through rapid leaf osmotic adjustment which lowered the leaf water potential at the turgor loss point beyond the minimum leaf water potential. Morphological adjustments, such as the reduction of leaf area to sapwood area (higher Huber Value) were moderate during the measurement period and only occurred under severe drought stress (pre-dawn water potential < −1.2 MPa). Overall, E. obliqua responded to short-term mild drought stress through physiological trait plasticity, while morphological adjustment only occurred under a more severe water deficit.

This study investigated for the first time the effect of drought on water relations, gas exchange, osmotic adjustment, and photoprotection mechanisms of local Arabica coffee cultivars namely, Dawairi, Tufahi, Kholani and Tessawi grown in Southwestern Saudi Arabia. Two-year-old plants growing in pots were subjected to water stress by withholding watering for four weeks. Water relations and gas exchange measurements revealed that the severity of the stress varied among cultivars. The most contrasting behavior was between the two cultivars Dawairi (drought-tolerant) and Kholani (drought-sensitive). Tufahi and Tessawi, however, showed intermediate tolerance. Under drought stress, Dawairi trees were able to maintain higher leaf water content (WC), plant turgor potential (Ψp) and net photosynthetic assimilation rate (Anet) at a given predawn leaf water potential (Ψpd) than the other three cultivars. Irreversible wilting (turgor loss) occurred at leaf Ψpd of about −2.5 MPa for Kholani and about −3.5 MPa or lower for the other cultivars. The drought tolerant cultivar also showed the highest increase in instantaneous water-use efficiency (iWUE) under drought stress. All coffee cultivars were able to slow the onset of water stress by controlling transpiration (avoidance). But they did vary in their ability to avoid tissue dehydration under such stress. The reduction in Anet, transpiration rate (E) and stomatal conductance (gs) with decreasing Ψpd was earlier and more marked in Kholani and Tufahi than in Dawairi and Tessawi. Besides, the fluctuations in Ψpd and Ψmid revealed a contrasting behavior among the four cultivars. Under drought stress, Dawairi maintained the highest diurnal range of ∆Ψpd-mid and showed the highest daily re-saturation capability. Moreover, it had a greater capacity for osmotic adjustment through solute accumulation. In contrast, in Kholani and Tufahi the drought-induced accumulation of solutes was mainly passive due to dehydration of the leaves. Moreover, Dawairi and Tessawi accumulated more proline in their leaves than the two other cultivars under stress. Drought stress considerably altered total soluble sugar (TSS) concentration in most cultivars. Surprisingly, the decrease in TSS content was more pronounced in drought tolerant cultivars. Photoinhibition occurred in all four cultivars when subjected to drought stress albeit with variable severity. Moderate stress decreased the quantum efficiency of PSII (ΦPSII), photochemical fluorescence quenching (qP) and electron transport rate (ETR), and increased the non-photochemical quenching (NPQ); this implies dynamic photoinhibition in all cultivars. However, when drought became severe towards the end of the experiment, the decrease in ΦPSII, qP and ETR was accompanied by a decline in Fv/Fm indicating the occurrence of chronic photoinhibition in most cultivars. Still photoinhibition was more obvious in Kholani and Tufahi. Interesting genetic differences in drought tolerance appear to exist among these four economically important Arabica coffee cultivars.

Current forest planting in Queensland, Australia, is concentrated in the humid coastal zone with mean annual rainfall greater that 1000 mm. However, further expansion will be concentrated in a lower rainfall (600 to 1000 mm) zone, for which Eucalyptus cloeziana F.Muell. and Eucalyptus argophloia Blakely are favoured native species. This study investigated ecophysiological characteristics of E. argophloia (dry inland), and dry inland and coastal (humid) provenances of E. cloeziana in response to changes in soil water availability, temperature, photon flux density and vapour pressure deficit as an aid to site-species matching for this plantation enterprise. Effects of water stress duration and intensity on gas exchange, leaf water relations, water use efficiency and biomass production were investigated in potted seven-month-old seedlings supplied with 100% (W100), 70% (W70), 50% (W50) of water required daily to restore field capacity or were watered when they were wilted at dawn (W0). At W100, E. argophloia had the highest midday net photosynthetic rate (A), stomatal conductance (gs), stomatal density and predawn leaf water potential (Ppd). The E. cloeziana provenances did not differ in these attributes. The W70 and W50 treatments reduced A by 30% in E. argophloia argophloia, and by 55% in the E. cloeziana provenances. Following stress relief both A and gs recovered more quickly in E. argophloia and in the inland provenance of E. cloeziana than in the humid provenance. Leaf water relations analyses revealed lower relative water content at turgid loss point, apoplastic water content, ratio of dry weight to turgid weight and bulk modulus of elasticity in both the dry and humid provenances of E. cloeziana than in E. argophloia. The E. cloeziana provenances maintained turgor at moderate water deficits by a combination of osmotic and elastic adjustments whereas E. argophloia had more rigid cell walls and reached lower water potentials at a higher relative water content. Eucalyptus argophloia produced twice as much biomass at W100, more than three times as much at W70 and W50, and allocated 10% more biomass to roots than did either E. cloeziana provenance. The humid provenance of E. cloeziana had a greater leaf area at W100 than the dry provenance but both suffered extensive leaf loss under severe water deficits. Biomass allocation patterns were significantly affected by genotype but not by soil water availability. Transpiration efficiency (dry weight gain/transpiration, WUET) did not differ between provenances at W100, but was significantly higher in E. argophloia than in either E. cloeziana provenance as available soil moisture decreased. Midday instantaneous water use efficiency (net assimilation/transpiration, WUEi) was lowest in E. argophloia. Carbon isotope composition (d13C) values for E. argophloia in all three water regimes were significantly lower than those of E. cloeziana provenances, which did not differ significantly. For all three provenances, d13C was not correlated with WUEi or WUET. Acclimation of gas exchange to temperature and light was determined in 18-month-old potted plants grown at day/night temperatures of 18/13, 23/18, 28/23 and 33/28 dC in controlled-temperature glasshouses for four months. There were no significant differences in the shape and quantum yield parameters of light response curves among provenances at 23, 28 and 33 dC day temperatures. Average values of dark respiration for the three provenances ranged from 0.61 to 1.86 mmol -2 s-1. The optimum temperatures for net photosynthesis increased from 23 to 32 dC for the humid and 25 to 33 dC for the dry provenances of E. cloeziana and from 21 to 33 dC for E. argophloia as daytime temperature of the growth environment increased from 18 to 33 dC. Physiological responses to diurnal and seasonal changes in soil water availability, leaf temperature and leaf-to-air vapour pressure deficit (VPD) were investigated in four-year-old trees in field plantings in southeast Queensland. Water relations of Eucalyptus argophloia and the Hungry Hills provenance of E. cloeziana suggested possible access to water at depth. Prediction models for net photosynthesis and phenomenological models of stomatal conductance explained 60 to 80% of observed variation in A and gs. E. argophloia has potential for plantation forestry in the humid and subhumid tropics, shown by high dry matter production rates under both high and low soil water availability in the glasshouse environment. Leaf water relations suggested that the relatively low cell wall elasticity, the maintenance of high relative water content and development of a large soil-plant water potential gradient were important characteristics in maintaining a large foliage mass under water limiting conditions in E. argophloia. E. cloeziana has considerable potential for use in plantations in humid conditions, but has limited potential under moderate and severe water deficit conditions. This is demonstrated by the ability of the species to produce large leaf area and high ratio of above to below ground biomass allocation under moist conditions but an inability to maintain that leaf area under water deficit conditions.n

The main tree water status indicators which sensitively responded to drought stress and related to tree water balance were investigated in treatment of progressive decrease of soil water potential under shelter from rain. The results showed that stem maximum daily shrinkage (MDS) and midday stem water potential (Ψstem) were most sensitive to drought stress among all the water status indicators. MDS not only significantly responded to reference crop evapotranspiration (ET0), but also was sensitive to soil drought stress. MDS was significantly positively related to ET0, and the correlation between relative stem daily maximum shrinkage (MDSr) and relative soil water potential (Ψr soil) was highly significant. Moreover, the stems could be measured in succession and recorded automatically. Midday Ψstem was also sensitive to soil drought stress, and significantly negatively related to ET0. The correlation between relative midday stem potential (Ψr stem) and Ψr soil was significant. But so far, it is difficult to automatically measure either leaf or stem water potential. Predawn leaf water potential (Ψpd), daily stem growth (DG) or stomatal conductance (gs) also responded to drought stress to some extent under moderate or heavy drought stress, but they were not sensitive.

The isoprostanes (IsoPs) are a unique series of prostaglandin-like compounds formed in vivo via a nonenzymatic mechanism involving the free radical-initiated peroxidation of arachidonic acid. This article summarizes our current knowledge of these compounds. Herein, a historical account of their discovery and the mechanism of their formation are described. A specific class of IsoPs, the F2-IsoPs, are stable, robust molecules that can be measured as indices of endogenous oxidant stress. The utility of these molecules as biomarkers and methods by which these compounds can be quantified are discussed. In addition to the F2-IsoPs, isoprostanes with other prostane ring structures as well as oxidation products with furan and dioxolane rings can be generated from arachidonic acid. And, in more recent years, isoprostane-like compounds have been shown to be formed from polyunsaturated fatty acids including eicosapentaenoic acid [C20:5, omega-3], docosahexaenoic acid [C22:6, omega-3], and adrenic acid [C22:4, omega-6]. These findings will be summarized as well.

Seasonal trends in pre-dawn leaf water potential and morning and afternoon rates of light-saturated assimilation and stomatal conductance were studied in saplings of the deciduous tree Terminalia ferdinandiana Excell. Mean daily maximum assimilation rates ranged from 11 µmol m-2 s-1 in the wet season to 8 µmol m-2 s-1 during the transition from the wet to the dry season. Saplings were without leaves from June to October inclusive (dry season). There was a log–linear relationship between stomatal conductance and pre-dawn leaf water potential (r = 0.76, n = 325), and a weak linear relationship between daily maximum assimilation and pre-dawn leaf water potential (r = 0.39, n = 184). Assimilation rates were higher in the morning than in the afternoon in April and May, but were similar throughout the day from December to March. Seasonal trends in assimilation could be attributed primarily to stomatal closure, but diurnal differences could not. High leaf temperatures may have been responsible for observed lower assimilation rates in the afternoon in April and May. Assimilation and stomatal conductance decreased when leaf temperatures rose above 38˚C and/or the leaf-to-air vapour pressure difference exceeded 4–4.5 kPa. Pre-dawn leaf water potentials decreased more quickly, and stomatal conductance was more sensitive to this decrease, in T. ferdinandiana saplings than in saplings of Eucalyptus tetrodonta F.Muell. a co-occurring evergreen tree. Specific leaf area and assimilation per unit dry weight were higher in T. ferdinandiana than in E. tetrodonta which is consistent with other studies of costs and benefits of deciduousness.

Chronic glaucoma is a multifactorial disease among which oxidative stress may play a major pathophysiological role. We conducted a systematic review and meta-analysis to evaluate the levels of oxidative and antioxidative stress markers in chronic glaucoma compared with a control group. The PubMed, Cochrane Library, Embase and Science Direct databases were searched for studies reporting oxidative and antioxidative stress markers in chronic glaucoma and in healthy controls using the following keywords: “oxidative stress” or “oxidant stress” or “nitrative stress” or “oxidative damage” or “nitrative damage” or “antioxidative stress” or “antioxidant stress” or “antinitrative stress” and “glaucoma”. We stratified our meta-analysis on the type of biomarkers, the type of glaucoma, and the origin of the sample (serum or aqueous humor). We included 22 case-control studies with a total of 2913 patients: 1614 with glaucoma and 1319 healthy controls. We included 12 studies in the meta-analysis on oxidative stress markers and 19 on antioxidative stress markers. We demonstrated an overall increase in oxidative stress markers in glaucoma (effect size = 1.64; 95%CI 1.20–2.09), ranging from an effect size of 1.29 in serum (95%CI 0.84–1.74) to 2.62 in aqueous humor (95%CI 1.60–3.65). Despite a decrease in antioxidative stress marker in serum (effect size = –0.41; 95%CI –0.72 to –0.11), some increased in aqueous humor (superoxide dismutase, effect size = 3.53; 95%CI 1.20–5.85 and glutathione peroxidase, effect size = 6.60; 95%CI 3.88–9.31). The differences in the serum levels of oxidative stress markers between glaucoma patients and controls were significantly higher in primary open angle glaucoma vs primary angle closed glaucoma (effect size = 12.7; 95%CI 8.78–16.6, P < 0.001), and higher in pseudo-exfoliative glaucoma vs primary angle closed glaucoma (effect size = 12.2; 95%CI 8.96–15.5, P < 0.001). In conclusion, oxidative stress increased in glaucoma, both in serum and aqueous humor. Malonyldialdehyde seemed the best biomarkers of oxidative stress in serum. The increase of some antioxidant markers could be a protective response of the eye against oxidative stress.

The aim of the present study was to demonstrate the ameliorative effect of potassium phosphate on water stress tolerance in the BRNADINE 5656 variety of tomato (Solanum lycopersicum L.). The nine treatments studied were made by mixing two levels of potassium phosphate (0.5 g/L and 1 g/L) with three different irrigation schedules based on field size: 100%, 75% and 50%. The experiment was conducted under natural conditions in an intelligent agro-photovoltaic greenhouse in pots containing 2.5 kg of a mixture of soil (70%) and peat (30%). The measurements performed related to growth parameters (aerial and root biomass, stem and root length, number of leaves and fruits), water content and biochemical parameters (proline, soluble sugars, chlorophyll (a), (b) and carotenoids content). The results obtained showed that water stress reduced all measured parameters, confirming the sensitivity of tomato. The reductions varied according to the severity of stress (-7% to -56%). Under water stress, the addition of KH₂PO₄ only had a beneficial effect on root dry mass, and on the water content of the aerial part, chlorophyll pigments, and carotenoids. In the presence of 1 g/L of KH₂PO₄, the water content of the aerial part increased from 1.86 to 2.63 mL·g⁻¹ DW and from 1.77 to 3.57 mL·g⁻¹ DW under moderate and severe water deficit, respectively, compared to the control of each stressed treatment. For the same treatment, root biomass increased from 5.84 to 11.43 g DW and from 5.46 to 7.85 g DW under moderate and severe water deficit, respectively. Similarly, the contents of chlorophyll (a), (b), and carotenoids increased by 40.92% and 20.66%, 62.34% and 39.93%, and 59.6% and 36.14% under moderate and severe stress, respectively. Keywords: Solanum lycopersicum L., abiotic stress, drought stress, agronomic parameters, water potential, stomatal conductance

Coffea arabica cv. Red Catuai and C. canephora cv. Kouillou were grown in pots beneath a plastic shelter. When they were 14 months old, irrigation was withheld until the leaf pre-dawn water potential was about -1.5 and -2.7 MPa (designated mild and severe water stress, respectively). Under mild stress, net photosynthetic rate (PN) decreased mainly as a consequence of stomatal limitations in Kouillou, whereas such decreases were dominated by non-stomatal limitations in Catuai. Under severe drought, further decreases in PN and apparent quantum yield were not associated to any changes in stomatal conductance in either cultivar. Decreases were much more pronounced in Catuai than in Kouillou, the latter maintained carbon gain at the expense of water conservation. In both cultivars the initial chlorophyll (Chl) fluorescence slightly increased with no changes in the quantum efficiency of photosystem 2. In response to rapidly imposed drought, the Chl content did not change while saccharide content increased and starch content decreased. Photoinhibition and recovery of photosynthesis, as evaluated by the ratio of variable to maximum fluorescence and by the photosynthetic O2 evolution, were unaffected by mild drought stress. Photoinhibition was enhanced under severe water deficit, especially in Catuai. In this cultivar the O2 evolution did not resume upon reversal from photoinhibition, in contrast to the complete recovery in Kouillou.

Isohydric plants maintain constant water potential through rapid stomatal closure, whereas anisohydric plants only close their stomata at very low water potentials. However, distinctions between isohydric and anisohydric behaviors among different cultivars of the same species are unclear. This study compared the physiological response to prolonged drought stress in the isohydric Grenache and the anisohydric Shiraz cultivars of the <i>Vitis vinifera</i> species. Plants were exposed to 60-day periods of deficit irrigation (25% of plant water consumption under well-watered conditions) during the summers of 2011 and 2012. Physiological measurements, water potential, leaf gas exchange, canopy area, leaf senescence, stem characteristics, and morphological characteristics were analyzed. Stomatal conductance was consistently lower in Grenache than in Shiraz at all values of midday stem and predawn leaf water potentials, respectively. The Shiraz plants exhibited greater vegetative growth and less defoliation than the Grenache plants in response to water deficit. Anatomical architecture analyses revealed that Grenache plants had greater xylem vessel diameter, hydraulic conductivity, and stomatal density than the Shiraz plants. These results suggest isohydric and anisohydric behaviors may be well-defined, time-regulated responses rather than distinct mechanisms that plants use to cope with drought stress. The rapid response to water deficit exhibited by isohydric plants may be because they are more vulnerable to fatal xylem embolisms than anisohydric plants. Thus, the accelerated response allows isohydric plants to avoid drought stress and minimize risk of xylem cavitation, but may lower the plant’s ability to survive moderate stress of prolonged drought.

We read with great interest the article by Kavakli et al. in which the total oxidant and the antioxidant status were investigated in patients with carbon monoxide (CO) poisoning. Although lipid peroxidation has been linked to CO-induced neuropathology for more than two decades, serum levels of oxidative stress markers have not been investigated before. In this study, they measured, in patients with CO poisoning (n 1⁄4 88) and control subjects (n 1⁄4 37), serum levels of total oxidant and antioxidant status and calculated oxidative stress index (1⁄4 total oxidant status/total antioxidant status). They found that total oxidant status and oxidative stress index, but not total antioxidant status significantly increased in patients with CO poisoning when compared with controls. Additionally, they found that carboxyhemoglobin (COHb), total oxidant status and oxidative stress index were significantly reduced after 6 h of treatment. We applaud their efforts to gain insight into the pathophysiology of CO poisoning, which is a frequent cause of morbidity and mortality in Turkey. In the discussion, they conclude that ‘ . . . oxidative stress index may be a useful guide in planning treatment of CO poisoned patients’ and ‘ . . . in decision of hyperbaric oxygen therapy application, oxidative stress index levels should be taken into consideration’. We think that the data presented in this article is not sufficient to support their conclusion that oxidative stress index is a marker of severity and can be used in the selection of patients for hyperbaric oxygen therapy. Oxygen is first-line therapy in CO poisoning. Severely poisoned patients are referred to hyperbaric oxygen therapy. In order to argue that oxidative stress index can discriminate severely poisoned patients, they should have compared oxidative stress index levels in mild, moderate and severely poisoned patients. They could also analyze whether there is a correlation between COHb and oxidative stress markers. If the data is available, the authors could also analyze the correlation between oxidative stress markers and the number of clinical manifestations. Interestingly, in a recent study Garrabou et al. measured serum levels of lipid peroxidation (oxidative stress) in patients with CO poisoning and analyzed its correlation with clinical findings. Although, serum levels of lipid peroxidation were similar in patients with moderate and severe CO poisoning, pretreatment lipid peroxidation level was strongly correlated with the total number of symptoms along the 3 months follow-up. In addition, pretreatment lipid peroxidation was significantly higher in patients who developed late neurological sequel (LNS) compared with those without LNS. Since COHb poorly correlates with severity of CO poisoning, new serum markers are needed to evaluate severity and outcome of patients with CO poisoning. Further studies are needed to elucidate the value of oxidative stress markers in the management of CO poisoning.

Foliar application of phosphoric acid mitigates oxidative stress induced by herbicides in soybean, maize, and cotton crops

BACKGROUND: Skin is the body's fi rst defence against direct exposure to variety of chemicals. Polycyclic aromatic hydrocarbons such as 3-methylcholanthrene (3-MC) are common in polluted urban air and have a potential of producing harmful effects. Moreover, their late effects can occur months or years after exposure. OBJECTIVES: We aimed to investigate the long-term effects of 3-MC induced dermal toxicity on the expression of markers of apoptosis, pleiotropic cytokines, and oxidative stress and to determine the protective effect of cisplatin. METHODS: Groups were designed as control (group 1), 3-MC applied (group 2) and 3-MC+cisplatin applied mice (group 3). Cutaneous expressions of TGF, PDGFA, PDGFC, bFGF, PDGFR, USP28, and Ki67 were evaluated with qPCR. Total oxidant (TOS), total antioxidant (TAS) and oxidative stress index (OSI) values were determined in liver and kidney tissues. RESULTS: The expression levels of TGF, PDGFR, USP-28, Ki67, and PDGFA were decreased signifi cantly in MC applied groups. Renal TAS levels were signifi cantly lower in group-3. Liver and kidney OSI values were increased in both groups 2 and 3. CONCLUSION: The results indicated that low dose 3-MC caused oxidative stress and downregulated apoptotic and cytokine markers in the long term and cisplatin had no ameliorative effects on this degeneration processes (Tab. 3, Fig. 3, Ref. 32).

We assessed the effects of candesartan in addition to angiotensin-converting enzyme (ACE) inhibitors on N-terminal pro-type natriuretic peptide (Nt-proBNP), systemic markers of inflammation and oxidative stress as well as on glucose regulation in patients with heart failure (HF). Eighty patients with HF ages 62.5 +/- 8.4 years presenting mostly with New York Heart Association class II symptoms (class II = 57.5%, III = 41.3%), and mean left ventricular ejection fraction 27.1 +/- 7.3% were recruited. The patients were randomized to receive candesartan titrated to 32 mg 1 per day versus placebo in double-blind fashion for 6 months. Nt-proBNP, markers of inflammation and oxidative stress, glucose, insulin, and fasting insulin resistance index were analyzed. Candesartan decreased Nt-proBNP (median value = 12.4% versus -20.4%; [candesartan] P = .05), and high-sensitivity C-reactive protein (hsCRP) (+5.32% versus -20.3% [candesartan]; P = 0.046), without significantly influencing serum interleukin-6, interleukin-18, adhesion molecules, or markers of oxidative stress. Blood glucose decreased in patients treated with candesartan with a significantly greater effect in patients with higher blood glucose levels (P < .01 for interaction). The addition of candesartan to ACE inhibitor and beta-blocker decreases Nt-proBNP and hsCRP, but does not change the other markers of inflammation or oxidative stress in patients with heart failure. Dual angiotensin-II suppression also decreased blood glucose with a greater impact in patients with higher blood glucose level.