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December 14, 2001


Emory Researchers Study Inflammation's Role in Atherosclerosis

Does a common hormone known as angiotensin II play an important role in the development of atherosclerosis, the build up of cholesterol and scar tissue inside arteries? AIMS, the Atherosclerosis and Inflammatory Markers Study based at Emory University, is designed to help answer that question.

Angiotensin II is not a "bad" hormone, according to Emory Heart Center cardiologist W. Robert Taylor, M.D., Ph.D. In fact, it is necessary for control of homeostasis -- it helps regulate blood pressure control. However, as we age, the hormone produces reactions in blood vessels that may contribute to heart disease.

"During our reproductive years angiotensin II helps keep us alive if we are subjected to some serious injury or extreme physical stress," explains Dr. Taylor, chief investigator for AIMS. "But after middle age or so, it has some negative effects on the vessel walls. It produces an inflammatory response which is believed to be an important part of the development of atherosclerosis."

Angiotensin II already has been linked to the development of atherosclerosis in several ways. "There are data from our basic science lab that demonstrate that giving angiotensin II to animals accelerates the development of atherosclerosis. Importantly, the converse is also true in that blocking endogenous angiotensin II prevents the development of atherosclerosis," says Dr. Taylor. "In addition, there are some human data that suggest that this is true in people, too. For example, when we look at outcomes in patients treated with ACE (angiotensin converting enzyme) inhibitors which block angiotensin II formation, cardiovascular mortality is lower."

Emory researchers will look at the effect of an angiotensin II receptor blocker on serum markers of atherosclerosis such as growth factors, cytokines and other signs of vascular inflammation and oxidative stress, according to Dr. Taylor. AIMS, which is sponsored by Sankyo Pharma Inc.'s Development Division, hopes to enroll approximately 220 patients with peripheral vascular disease (PVD) involving the lower extremities. In PVD, a disease that affects approximately eight million people in the U.S., arteries that carry blood to the legs (or, less often, the arms) become narrowed or clogged by atherosclerosis, slowing or stopping the flow of blood.

Half of the study participants will receive a placebo and half will receive a new angiotensin II blocker known as CS866 (also called olmesartan) .Blood tests for atherosclerosis markers as well as ultrasound studies documenting vascular reactivity and the health of blood vessels will be performed over a period of 12 months.

Most patients with PVD who are in stable condition and are not currently taking an ACE inhibitor or angiotensin receptor blocker are eligible to participate in the study. For information on referring a patient to participate in AIMS, call Jane Guidot at 404-321-6111, ext. 4183.

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