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To the Editor:Azekoshi et al1 demonstrated that the enhanced production of angiotensin II by free fatty acid in mononuclear and polymorphonuclear cells caused activation of leukocytes that consequently impairs endothelial function. Obesity, metabolic syndrome, and type 2 diabetes mellitus are major risk factors for cardiovascular disease. This study strongly supports our hypothesis that reciprocal relationships between insulin resistance and endothelial dysfunction contribute to the development of cardiovascular events through inflammatory actions.2 Thus, therapies should target the vicious synergy between endothelial dysfunction and insulin resistance to prevent cardiovascular events.In that point, inhibitors of the renin-angiotensin …

Role of Renin-Angiotensin System Blockades in Reciprocal Relationship Between Insulin Resistance and Endothelial Dysfunction