THE EFFECT OF ENALAPRIL WITH AND WITHOUT HYDROCHLOROTHIAZIDE ON INSULIN SENSITIVITY AND OTHER METABOLIC ABNORMALITIES OF HYPERTENSIVE PATIENTS WITH NIDDM

被引：36
作者：
SHAMISS, A [1 ]
CARROLL, J [1 ]
PELEG, E [1 ]
GROSSMAN, E [1 ]
ROSENTHAL, T [1 ]
机构：
[1] CHAIM SHEBA MED CTR,AJ CHORLEY INST HYPERTENS,IL-52621 TEL HASHOMER,ISRAEL
来源：
AMERICAN JOURNAL OF HYPERTENSION | 1995年 / 8卷 / 03期
关键词：
ENALAPRIL; HYDROCHLOROTHIAZIDE; HYPERTENSION; INSULIN SENSITIVITY; NON-INSULIN-DEPENDENT DIABETES MELLITUS;
D O I：
10.1016/0895-7061(94)00181-A
中图分类号：
R6 [外科学];
学科分类号：
1002 ; 100210 ;
摘要：
The effect of 20 mg of enalapril with and without 12.5 mg of hydrochlorothiazide on glucose metabolism insulin sensitivity and lipids was evaluated in hypertensive non-insulin-dependent diabetes. Ten mild to moderate hypertensive patients with noninsulin-dependent diabetes mellitus were treated for 8 weeks with 20 mg enalapril once a day, and then divided into two groups of 5 patients each for a second 8 weeks of treatment with enalapril alone or in combination with hydrochlorothiazide, 12.5 mg once a day. Blood pressure, fasting plasma glucose, lipids and insulin, glycosylated hemoglobin, and insulin sensitivity were measured at baseline and after 8 and 16 weeks. Results were analyzed by the ANOVA test for repeated measures and all values are given as mean +/- SD. Diastolic blood pressure decreased significantly after the first and second period of enalapril and after the combination of enalapril and hydrochlorothiazide. Glycosylated hemoglobin dropped significantly after the first and second period of enalapril monotherapy. Plasma triglycerides and fasting plasma insulin decreased significantly after the 16 weeks of enalapril. Insulin-mediated glucose uptake increased significantly after 8 and 16 weeks of monotherapy with enalapril. No significant difference was observed in any of the metabolic characteristics, including insulin sensitivity, between the values after 8 weeks of enalapril alone and the final values of the enalapril-treated and the enalapril/hydrochlorothiazide-treated groups. It is concluded that enalapril improves some of the metabolic parameters, including insulin sensitivity, of hypertensive diabetic patients. Despite the small number of hydrochlorothiazide patients, these results lead us to suggest that the coadministration of low-dose hydrochlorothiazide may not adversely affect these parameters, and that enalapril may have blunted the metabolic adverse effect of the diuretic.
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页码：276 / 281
页数：6
相关论文
共 37 条
  • [1] Reaven, Role of insulin resistance in human disease, Diabetes, 37, pp. 1595-1607, (1988)
  • [2] Defronzo, Ferrannini, Insulin resistance: a multifaceted syndrome responsible for NIDDM obesity, hypertension, dyslipidemia and atherosclerotic cardiovascular disease, Diabetes Care, 14, pp. 173-194, (1991)
  • [3] Fuller, Epidemiology of hypertension associated with diabetes mellitus, Hypertension, 7, (1985)
  • [4] Pollare, Lithell, Berne, A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension, N Engl J Med, 321, pp. 868-873, (1989)
  • [5] Bllomgarden, Ginsberg-Fellner, Rayfield, Bookman, Brown, Elevated hemoglobin Alc and low density lipoprotein cholesterol levels in thiazidetreated diabetic patients, The American Journal of Medicine, 77, pp. 823-827, (1984)
  • [6] Nguyen, Er tiazider diabetogene, Tidsskr-Nor-Laegeforen, 113, pp. 2587-2589, (1993)
  • [7] Prince, Stuart, Padia, Et al., Metabolic effects of hydrochlorothiazide and enalapril during treatment of the hypertensive diabetic patient, Arch Intern Med, 148, pp. 2363-2368, (1988)
  • [8] Ferriere, Lachkar, Richard, Et al., Captopril and insulin sensitivity, Ann Intern Med, 102, pp. 134-135, (1985)
  • [9] McMurray, Fraser, Captopril, enalapril and blood glucose, Lancet, 1, (1986)
  • [10] Alkharouf, Nalinikumari, Corry, Tuck, Long-term effects of the angiotensin convering enzyme inhibitor captopril on metabolic control in non-insulin-dependent diabetes mellitus, Am J Hypertens, 6, pp. 337-343, (1993)
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