The bimodal regulation of vascular function by superoxide anion: role of endothelium

Reactive oxygen species (ROS) are implicated in vascular homeostasis. This study investigated whether O2 .

Telmisartan to prevent recurrent stroke and cardiovascular events

Background Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin–angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood pressure with a renin–angiotensin system inhibitor soon after a stroke has not been clearly established. We evaluated the effects of therapy with an angiotensin-receptor blocker, telmisartan, initiated early after a stroke. Methods In a multicenter trial involving 20,332 patients who recently had an ischemic stroke, we randomly assigned 10,146 to receive telmisartan (80 mg daily) and 10,186 to receive placebo. The primary outcome was recurrent stroke. Secondary outcomes were major cardiovascular events (death from cardiovascular causes, recurrent stroke, myocardial infarction, or new or worsening heart failure) and new-onset diabetes. Results The median interval from stroke to randomization was 15 days. During a mean followup of 2.5 years, the mean blood pressure was 3.8/2.0 mm Hg lower in the telmisartan group than in the placebo group. A total of 880 patients (8.7%) in the telmisartan group and 934 patients (9.2%) in the placebo group had a subsequent stroke (hazard ratio in the telmisartan group, 0.95; 95% confidence interval [CI], 0.86 to 1.04; P = 0.23). Major cardiovascular events occurred in 1367 patients (13.5%) in the telmisartan group and 1463 patients (14.4%) in the placebo group (hazard ratio, 0.94; 95% CI, 0.87 to 1.01; P = 0.11). New-onset diabetes occurred in 1.7% of the telmisartan group and 2.1% of the placebo group (hazard ratio, 0.82; 95% CI, 0.65 to 1.04; P = 0.10). Conclusions Therapy with telmisartan initiated soon after an ischemic stroke and continued for 2.5 years did not significantly lower the rate of recurrent stroke, major cardiovascular events, or diabetes. (ClinicalTrials.gov number, NCT00153062.)

The ethical ambivalence of resistant violence: notes from postcolonial south Asia

In the face of mounting militarism in south Asia, this essay turns to anti-state, ‘liberatory’ movements in the region that employ violence to achieve their political aims. It explores some of the ethical quandaries that arise from the embrace of such violence, particularly for feminists for whom political violence and militarism is today a moot point. Feminist responses towards resistant political violence have, however, been less straightforward than towards the violence of the state, suggesting a more ambivalent ethical position towards the former than the latter. The nature of this ambivalence can be located in a postcolonial feminist ethics that is conceptually committed to the use of political violence in certain, albeit exceptional circumstances on the basis of the ethical ends that this violence (as opposed to other oppressive violence) serves. In opening up this ethical ambivalence – or the ethics of ambiguity, as Simone de Beauvoir says – to interrogation and reflection, I underscore the difficulties involved in ethically discriminating between forms of violence, especially when we consider the manner in which such distinctions rely on and reproduce gendered modes of power. This raises particular problems for current feminist appraisals of resistant political violence as an expression of women's empowerment and ‘agency’.