Related Experiment Videos
Improvement in metabolic risk factors for coronary heart disease associated with cilazapril treatment
S M Shieh1, W H Sheu, D D Shen
1Division of Cardiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
Insights
Angiotensin converting enzyme (ACE)-inhibitor cilazapril improved glucose and insulin responses in hypertensive patients. Adding hydrochlorothiazide (HC) negated these beneficial metabolic effects, highlighting ACE-inhibitors
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Pharmacology
Background:
- Hypertension is frequently associated with metabolic abnormalities like glucose intolerance and dyslipidemia, increasing coronary heart disease (CHD) risk.
- Understanding the impact of antihypertensive treatments on these metabolic factors is crucial for comprehensive cardiovascular risk management.
Purpose of the Study:
- To investigate the effects of an angiotensin converting enzyme (ACE)-inhibitor, cilazapril, alone and in combination with hydrochlorothiazide (HC), on glucose and insulin metabolism in hypertensive patients.
- To assess the impact of antihypertensive therapy on lipid profiles and coronary heart disease risk factors.
Main Methods:
- An open-labelled, uncontrolled study involving 19 hypertensive patients.
- Patients were treated with cilazapril, with hydrochlorothiazide added as needed for blood pressure control.
- Plasma glucose and insulin responses to oral glucose challenge, along with lipid concentrations, were measured at baseline, 26 weeks, and 52 weeks.
Main Results:
- Patients receiving cilazapril alone (n=9) showed a significant decrease in plasma glucose (8%) and insulin (25%) responses (P < .05 and P < .002, respectively).
- Patients treated with cilazapril plus hydrochlorothiazide (n=10) did not exhibit significant changes in glucose or insulin responses.
- Both treatment groups achieved similar blood pressure control without significant differences in age, sex, or body mass index.
Conclusions:
- Cilazapril monotherapy demonstrates favorable effects on glucose and insulin metabolism in hypertensive individuals.
- The addition of hydrochlorothiazide to cilazapril may attenuate or abolish these beneficial metabolic improvements.
- These findings suggest that the choice of antihypertensive medication can influence metabolic profiles and potentially CHD risk.
Abstract:
Patients with hypertension tend to be glucose intolerant, hyperinsulinemic, and dyslipedemic. Since all of these changes increase risk of coronary heart disease (CHD), it is important to know what effect antihypertensive treatment has on these variables. The current open-labelled, uncontrolled study was initiated in order to extend our understanding of these issues. This study was performed in 19 patients with hypertension who were started on an angiotensin converting enzyme (ACE)-inhibitor, cilazapril, with hydrochlorothiazide (HC) added if needed to control blood pressure. Plasma glucose and insulin responses to oral glucose and lipid concentrations were measured before, 26, and 52 weeks after starting treatment. Patients treated with either cilazapril (n = 9) or cilazapril+HC (n = 10) did not differ in terms of original (mean +/- SEM) blood pressure (159 +/- 5/101 +/- 1 v 156 +/- 4/103 +/- 2 mm Hg), age (53 +/- 2 v 54 +/- 2 years), sex distribution (5M:4F v 7M:3F), or body mass index (24.4 +/- 0.5 v 24.2 +/- 0.9 kg/m2). Blood pressure was also similar after 26 (137 +/- 4/88 +/- 1 v 133 +/- 3/90 +/- 1 mm Hg) and 52 (137 +/- 4/87 +/- 1 v 134 +/- 4/89 +/- 2 mm Hg) weeks of treatment. Plasma glucose and insulin responses decreased by 8 +/- 3% (P less than .05) and 25 +/- 9% (P less than .002), respectively, in cilazapril-treated patients, but did not change in those treated with cilazapril plus HC.(ABSTRACT TRUNCATED AT 250 WORDS)