Patients with systemic lupus erythematosus (SLE) may develop cardiovascular disease as a result of endothelial dysfunction and a decrease in endothelial progenitor cells (EPCs) in peripheral blood. Vascular endothelial growth factor (VEGF) controls endothelial progenitor cell proliferation. In individuals with coronary heart disease, angiotensin-converting enzyme inhibitors lower cardiovascular mortality.
In the randomized experiment, 37 female SLE patients without cardiovascular risk factors were divided into the following 2 groups: 18 individuals were kept off of ramipril (CG), whereas 19 patients took 10 mg/d of it for 12 weeks (IG). EPCs were measured by flow cytometry and cell culture at baseline and after 12 weeks. Endothelial function was evaluated by brachial artery ultrasonography assessing flow-mediated dilation. An enzyme-linked immunosorbent test was used to determine the levels of serum VEGF. The goal of the statistical analysis was to treat. Significant was defined as P<0.05.
Following 12 weeks, IG showed stronger flow-mediated dilation (6.17% vs. 11.14%, P<0.001) but not CG (5.37% vs. 5.02%, P=0.630). There was no difference in the number of EPC colony-forming units between CG (P=0.714) and IG (21.3±10.4 vs. 31.6±8.5, P<0.001). EPCs examined by flow cytometry revealed no differences. After 12 weeks, the amount of vascular endothelial growth factor in IG rose (P=0.048), but there was no difference in CG (P=0.661).
In SLE patients without cardiovascular risk factors, ramipril enhanced endothelial function and increased the number of EPCs assessed by cell culture and VEGF levels. The findings implied that angiotensin-converting enzyme inhibitors have additional benefits in addition to their hypotensive effects, and they need to be given preference as antihypertensive medications for SLE patients.