Effect of Ramipril on the Incidence of Diabetes

In a 2-by-2 factorial design, participants without cardiovascular disease but with impaired fasting glucose levels or impaired glucose tolerance received ramipril or placebo (with or without rosiglitazone) for a median of 3 years. The results suggest that ACE inhibitors may modestly improve glucose metabolism, though ramipril failed to change the rate of death or newly diagnosed diabetes. ACE inhibitors may modestly improve glucose metabolism, though ramipril failed to change the rate of death or newly diagnosed diabetes. Diabetes, ranked as the fifth leading cause of death worldwide, is a major risk factor for various cardiovascular and renal disorders. 1 The prevalence of diabetes is increasing, which in turn increases the risk of premature cardiovascular disease and death. 2 Therefore, strategies to reduce the incidence of diabetes are needed. Physical activity, weight loss, 3 , 4 and some glucose-lowering agents 4 , 5 reduce the incidence of diabetes in people with elevated glucose levels that are just below the diagnostic threshold for diabetes. Several trials involving people with hypertension or cardiovascular disease have suggested that agents that block or inhibit the renin–angiotensin system may . . .