Effects of combination therapy with candesartan and ramipril on hypertension and related complications

Hypertension is a major risk factor for cardiovascular diseases and is known to contribute to complications, such as atherosclerosis and diabetes. The aim of this study was to investigate the possible synergistic effects of candesartan, an angiotensin II receptor blocker (ARB), and ramipril, an angiotensin-converting enzyme inhibitor (ACEI), in lowering high blood pressure in spontaneously hypertensive rats (SHRs). SHRs were given oral candesartan (1.53 mg/kg/day) and ramipril (0.48 mg/kg/day) for 2 weeks. The combination of candesartan and ramipril improved systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR) significantly compared with monotherapy. Additionally, combined treatment with candesartan (3.06 mg/kg/day) and ramipril (0.96 mg/kg/day) significantly decreased cuff-induced neointima hyperplasia and media thickness in C57BL/6 mice. In oral glucose tolerance tests (OGTTs), the combination of candesartan and ramipril significantly controlled blood glucose levels within 2 h after glucose loading in low-dose (38 mg/kg, i.p.) streptozotocin-treated Wistar rats. Taken together, the present study suggests that combination therapy with candesartan and ramipril may be a beneficial therapeutic strategy for the treatment of hypertensive patients with related complications, such as atherosclerosis and diabetes.