[Effect of cilazapril on insulin sensitivity in patients with essential arterial hypertension]

Insulin resistance is defined as a state with decreased insulin utilisation in peripheral tissues, despite of different plasma insulin values. Insulin resistance is one of the postulated pathophysiological mechanisms that participates in the development of essential hypertension. Hyperinsulinaemia is considered as a compensatory feature of insulin resistance. There way be a few possible mechanisms by which hyperinsulinaemia affects blood pressure. Another possibility is that insulin resistance per se, by some uncertain mechanisms, causes essential hypertension [1, 5]. We evaluated insulin sensitivity in 24 patients with mild-to-moderate essential hypertension before and after cilazapril monotherapy during 12 weeks. Insulin sensitivity (Si) was assessed by minimal model test (MINMOD) using frequently sampled intravenous glucose tolerance test in 0 week and after 12 weeks of treatment. After a 12-week cilazapril treatment insulin sensitivity significantly increased, while glucose efficacy was relatively unchanged.