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4. Discussion
Antihypertensive drugs ACEi trandolapril, is more
effective in inducing regression than non-RAS
inhibiting therapy

The angiotensin receptor blocker (ARB)
candesartan increases regression of retinopathy by
34% over placebo in type 2 diabetic patients
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Hypertension may increase the shear stress on the
vascular wall, leading to hyperplasia of the
vascular endothelium and to hypertrophia of its
cytoskeleton

Lowering BP might decrease the barotrauma to
the vascular wall and therefore prevent or regress
the microvascular changes of the diabetic retina.
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Throughout the observation period the
regression rate of diabetic retinopathy was
more than double in patients on trandolapril
than in controls
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5. Conclusions
Provided the evidence that diabetic retinopathy
can regress.

This may have important clinical implications since
regression of retinal damage may limit the risk of
visual loss in the long term.
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Costs can be further reduced by using the generic
compound that is currently available in most countries.

RAS inhibition with the ACEi trandolapril, verapamil, had a
beneficial effect from the reduction in arterial BP and blood
glucose

Importantly, the ACEi trandolapril, compared to the ARB
candesartan tested in the
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DIRECT-Protect 2 trial, has the advantage of
remarkably lower treatment costs with
trandolapril 2mg or candesartan 32 mg, resp.

Improving costeffectiveness in particular in
developing countries
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TITLE
Too long / short ?
Not more than 12 words, can illustrate
the journal content generally
Illustrate the observed
variables ?
Yes
Non standard Abbreviation? None
Any corresponding author
and email ?
Obviously, Piero Ruggenenti,
pruggenenti@ospedaliriuniti.bergamo
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ABSTRACT
Consists of 4 parts:
background, method, result,
and conclusion ?
Yes, 4 parts: background, method,
result, and conclusion
Any keywords ? None
Do the abstract is wholly
appropriate ?
Yes
AIM & BENEFIT OF THE RESEARCH
Does the aim explained ? Yes
Does the benefit explained ?
Yes
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METHODS
Is there any research design ? Yes, it is explained
Population & samples Yes, it is explained
Inclusion-Exclusion Criteria Yes, it is explained
Sampling & Sample size
formulation
Yes, it is explained

Did the subject selection is
appropriate?
Is there any bias ?
Incorrect, because only young and
healthy subject involved
Treatment Yes, it is explained
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METHODS
Did the measurement blind ? NO
Is there any bias on
procedure, means, and
subject obedience ?
NO
Is there any explanation
about independent &
dependent variables ?
Yes, it is explained
Is there any operational
definition ?
YES
Is there any ethical clearance
consent ?
NO
Data analysis ? Yes, using paired t-tests
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RESULTS
Any Drop out ? None
Is there any subject
characteristic table ?
None
Is there any aim for the
results?
Obviously
What is the main result of
the research ?
Unlike ndCCB, ACEi therapy have an
additional effect to promoting regression of
diabetic retinopathy.
DISCUSSION
Did the result suits the
theory ?
Yes
Is there any comparison
with another research ?
Yes, there is some similarities and
differences
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CONCLUSION
Could it be applied in
chosen sample, reachable
and target population ?
Yes, but it needs further research
Could this research be
applied for patients ?
Applicable