Compared with other angiotensin-converting enzyme (ACE) inhibitors, the elimination of temocapril is less dependent on renal function. To investigate the metabolic and antihypertensive effects of temocapril in diabetic hypertensives, 30 patients with diabetes mellitus type 2 and mild to moderate hypertension [diastolic blood pressure (BP) 90-115 mm Hg] and without azotemia (plasma creatinine < 180 microM) were evaluated in a prospective randomized double-blind placebo-controlled study. After a 4-week placebo run-in, they received temocapril, 20 mg daily (n = 19), or placebo (n = 11) for 6 weeks. Insulin sensitivity index (SI), determined by the Minimal Model method of Bergman, serum lipoproteins, plasma renin activity, fibrinogen, and microalbuminuria were assessed at the end of the placebo run-in phase and the double-blind treatment phases. Temocapril but not placebo administration produced a significant decrease in supine BP (152/92+/-5/3 vs. 162/98+/-5/2 mm Hg; p < 0.01) and increase in plasma renin (p < 0.05). Variation of SI during temocapril treatment did not reach statistical significance (0.95+/-0.2 before vs. 1.44+/-0.4 x 10(-4)/min/mU/L after treatment). During administration of temocapril or placebo, no significant changes in fasting plasma glucose, insulin, and serum levels of total triglycerides, cholesterol, lipoprotein cholesterol fractions, or fibrinogen were observed. Microalbuminuria decreased significantly on temocapril treatment (49+/-10 vs. 79+/-17 mg/24 h; p < 0.01) but not on placebo. These findings demonstrate that in hypertensive patients with diabetes mellitus type 2, short-term treatment with temocapril is neutral to insulin sensitivity, lipoprotein metabolism, and fibrinogen, and significantly reduces microalbuminuria.
The aim of this study was to evaluate the acute effect of a single bout of Tai Chi (TC) exercise on adiponectin and glucose homeostasis in individuals with cardiovascular risk factors. Twenty-six individuals (mean age 60.2 years) with at least one cardiovascular risk factor who had been practicing Yang's style TC exercise for at least 3 months were recruited from a regional hospital in Taiwan. A one-group repeated measured quasi-experimental design was used. Participants completed a 60-min Yang's style TC exercise routine including warm up, stretching exercises, and TC followed by a 30-min resting period. After a 1-week washout period, the same group of participants underwent a control condition in which they were instructed to remain seated for 90 min at the study location. Blood samples were collected both before and after the TC intervention or the sitting condition. The difference between pre-post measurements for adiponectin was 0.58 ± 1.42 μg/ml in the TC trial and -0.46 ± 0.99 μg/ml in the sitting trial. The differences between the two trials were statistically significant (P = 0.004). The changes from pretrial to posttrial were significantly greater for glycerol (P < 0.001), cholesterol (P = 0.046), and LDL-C (P = 0.038) in the TC trial compared with those in the sitting trial. Conversely, the changes were significantly lesser for HOMA-IR (P = 0.004), log (HOMA-IR) (P = 0.001), and glucose (P = 0.003) in TC trial compared with those in the sitting trial. In conclusion, a single bout of TC exercise had a significant positive effect on blood adiponectin concentrations in individuals with cardiovascular risk factors.
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