Glucose Tolerance During Chronic Captopril Therapy in Patients with Essential Hypertension

Shionoiri, Hiroshi; Miyakawa, Tomomi; Takasaki, Izumi; Ishikawa, Yoshihiro; Hiroto, Satoru; Kaneko, Yoshihiro; Shindo, Yasunori

doi:10.1097/00005344-198702000-00006

Cited by 18 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An increase in glucose tolerance has previously been observed with several ACE inhibitors [6,14,16,17], but not in all studies [21][22][23][24]. A proposed reason for this putative effect is an ACE inhibitorinduced resistance to the potassium-lowering effect of insulin [16].…”

Section: Discussionmentioning

confidence: 97%

Metabolic effects of long-term angiotensin-converting enzyme inhibition with fosinopril in patients with essential hypertension: relationship to angiotensin-converting enzyme inhibition

Reneland

Andersson

Haenni

et al. 1994

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Fifty patients with mild to moderate essential hypertension were randomized to receive either 20 mg fosinopril daily for 16 weeks or placebo for 4 weeks followed by 12 weeks of 50 mg atenolol daily. Prior to these 16 weeks there was a placebo wash-out period of 2-6 weeks. Blood pressure measurements, euglycaemic, hyperinsulinaemic glucose clamps, and intravenous glucose tolerance tests (IVGTT) were performed at baseline and after 4 and 16 weeks. Blood lipid status was evaluated at baseline and 16 weeks. The insulin sensitivity index (M/I) increased by 12% during the prolonged placebo period, and subsequently decreased by 12% during treatment with atenolol in that group. A post-hoc analysis of covariance indicated that the increase in insulin sensitivity during the initial 4 weeks may have been due to carry-over effects from previous antihypertensive treatment. Fosinopril increased glucose disappearance during IVGTT at 4 and 16 weeks (k values 1.46 and 1.33 vs 1.10 at baseline) but had no effect on insulin sensitivity. The change in insulin sensitivity and serum triglycerides during treatment with fosinopril was related to angiotensin-converting enzyme inhibition in serum. In conclusion, carry-over effects from previous antihypertensive medication were indicated in this study, probably because of an insufficient wash-out period in many patients. Therefore, 4 weeks of placebo wash-out in all patients is advisable in this kind of investigation.

show abstract

Section: Discussionmentioning

confidence: 97%

Metabolic effects of long-term angiotensin-converting enzyme inhibition with fosinopril in patients with essential hypertension: relationship to angiotensin-converting enzyme inhibition

Reneland

Andersson

Haenni

et al. 1994

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…Effect on glucose metabolism. In studies in nondiabetic hypertensives, prazosin therapy was shown to either lower (232,233) or at least not adversely affect (234) indices of glycemic control. Swislocki et al (235) reported that prazosin induces a significant decrease in insulin concentrations throughout the day while having no effect on glycemic excursion.…”

Section: A-blockersmentioning

confidence: 96%

“…Whereas Pollare et al (238) found that serum triglyceride and cholesterol concentrations and lipoprotein fractions were unaffected, other studies, in both hypertensive and diabetic patients with hypertension, have noted a lower LDL-HDL cholesterol ratio (235). Diminished serum triglyceride concentrations have also been reported (233,235). Conclusion.…”

Section: A-blockersmentioning

confidence: 97%

Drug Treatment of Hypertension in Patients With Diabetes Mellitus

Stein

Black

1991

Diabetes Care

View full text Add to dashboard Cite

Patients with diabetes mellitus have an increased prevalence of hypertension and its vascular consequences, including coronary and cerebrovascular disease. Drug treatment of hypertension in diabetic subjects is fraught with potential difficulties, including the altered efficacy of medications, the increased risk of side effects, and the possibility of worsening glycemic control and increasing serum lipid levels. Despite these difficulties, treatment is an important part of reducing morbidity and mortality from vascular events. Antihypertensive therapy may also have the potential to prevent or retard the development of diabetic nephropathy. In this article, we discuss the efficacy and metabolic and nonmetabolic side effects of the various classes of antihypertensive agents in patients with diabetes mellitus and suggest a stepped-care approach to the drug treatment of patients with hypertension and diabetes.

show abstract

“…Diabetes Care 13:1111-13, 1990 C ross-sectional community studies in non-insulindependent diabetes mellitus (NIDDM) patients (1) have not replicated experimental research findings that selected self-care behaviors can improve metabolic control (2)(3)(4). Self-care behaviors explained 26% of the variance in glycosylated hemoglobin levels in NIDDM patients.…”

Section: Self-care Predictors Of Metabolic Control In Niddm Patientsmentioning

confidence: 99%

“…Although many hypotensive agents have adverse effects on glucose tolerance and lipid metabolism (1), it has been reported that angiotensin-converting enzyme inhibitors (ACEIs) do not affect the plasma glucose concentration or insulin level during the oral glucose tolerance test, even in the case of long-term administration of captopril, the first orally available ACEI (2). Although many hypotensive agents have adverse effects on glucose tolerance and lipid metabolism (1), it has been reported that angiotensin-converting enzyme inhibitors (ACEIs) do not affect the plasma glucose concentration or insulin level during the oral glucose tolerance test, even in the case of long-term administration of captopril, the first orally available ACEI (2).…”

mentioning

confidence: 99%

Effect of Captopril on Glucose Concentration: Possible Role of Augmented Postprandial Forearm Blood Flow

et al. 1990

View full text Add to dashboard Cite

The goal of this study was to evaluate the effects of captopril on plasma glucose concentration. The daily profiles of the plasma glucose levels were determined in 12 non-insulin-dependent diabetic normotensive subjects, treated with or without captopril at a dose of 25 mg 3 times/day. Forearm blood flow was also measured by strain-gauge plethysmography. Administration of captopril improved the daily profile of the plasma glucose level. Postprandial forearm blood flow was also augmented 2 h after a meal. These results suggest that angiotensin-converting enzyme inhibitors may improve glucose metabolism in diabetic subjects, possibly through enhancement of blood flow to skeletal muscle.

show abstract

Glucose Tolerance During Chronic Captopril Therapy in Patients with Essential Hypertension

Cited by 18 publications

References 0 publications

Metabolic effects of long-term angiotensin-converting enzyme inhibition with fosinopril in patients with essential hypertension: relationship to angiotensin-converting enzyme inhibition

Metabolic effects of long-term angiotensin-converting enzyme inhibition with fosinopril in patients with essential hypertension: relationship to angiotensin-converting enzyme inhibition

Drug Treatment of Hypertension in Patients With Diabetes Mellitus

Effect of Captopril on Glucose Concentration: Possible Role of Augmented Postprandial Forearm Blood Flow

Contact Info

Product

Resources

About