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Background: This is the first study where suboptimal doses of enalapril proved to be successful for the reduction of arterial stiffness in in a clinical trial of rheumatoid arthritis (RA) patients. Objectives: The aim of this study was to analyze the effect of enalapril on arterials stiffness through the evaluation of subclinical parameters in RA patients without traditional cardiovascular risk factors or previous comorbidities. Methods: Fifty three patients were enrolled in a clinical, randomized, closed-label trial. The subjects were randomly assigned into two groups: One receiving 5 mg of enalapril (27) and 5 mg of placebo (26), both twice a day. Clinical assessment included a structured questionnaire to gather demographic and clinical variables, including disease duration, treatment, disease activity, laboratory, anthropometric measurements and determination of cardiovascular parameters [carotid femoral pulse wave velocity (cfPWV) (1), cardio-ankle vascular index (CAVI) (2), carotid intima media thickness (cIMT), carotid artery distensibility (3), Young‘s incremental elastic modulus (Einc)]. The whole set of evaluations were analyzed at the baseline and at the end of 12 weeks of intervention. Results: A significant reduction in delta CAVI of 0.21 in the enalapril intervention group was found. In contrast, an increase of 0.39 was observed in the placebo group. The delta CAVI reduction was not influenced by age or peripheral systolic blood pressure (pSBP). Conclusion: Enalapril seems to be effective in CAVI reduction in RA patients. The effect of enalapril intervention on arterial stiffness translated to the clinical context, might be interpreted as a reduction of 6.4 years of arterial aging. References [1] Vazquez-Del Mercado, M., et al., Disease duration of rheumatoid arthritis is a predictor of vascular stiffness: a cross-sectional study in patients without known cardiovascular comorbidities: A STROBE-compliant article. Medicine (Baltimore), 2017. 96(33): p. e7862. [2] Saiki, A., et al., The Role of a Novel Arterial Stiffness Parameter, Cardio-Ankle Vascular Index (CAVI), as a Surrogate Marker for Cardiovascular Diseases. J Atheroscler Thromb, 2016. 23(2): p. 155-68. [3] Vazquez-Del Mercado, M., et al., Subclinical parameters of arterial stiffness and arteriosclerosis correlate with QRISK3 in systemic lupus erythematosus. PLoS One, 2018. 13(12): p. e0207520. Disclosure of Interests: None declared |
