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Captopril does not alter metabolic control in elderly hypertensive diabetics during secondary failure
G De Mattia1, O Laurenti, G Tullo
1Istituto di I Clinica Medica, Università La Sapienza, Rome, Italy.
Insights
Captopril, an angiotensin converting enzyme inhibitor, effectively lowers blood pressure in elderly diabetic patients with hypertension. This study found no adverse effects on blood glucose control or insulin secretion, indicating its safety for managing cardiovascular complications.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Elderly patients with diabetes and hypertension face synergistic risks for cardiovascular complications.
- Therapeutic strategies must balance blood pressure reduction with glucose metabolism control.
- Secondary failure in diabetes necessitates careful medication selection to avoid metabolic disruption.
Purpose of the Study:
- To evaluate the safety and efficacy of captopril in elderly diabetic patients with secondary failure.
- To determine if captopril interferes with glucose metabolism or insulin secretion.
- To assess captopril's impact on blood pressure and heart rate in this specific patient group.
Main Methods:
- A study involving ten elderly hypertensive diabetic patients with secondary failure.
- Patients received captopril 100 mg/day for 30 days.
- Key parameters measured included blood pressure, heart rate, fructosamine, daily blood glucose profiles, and c-peptide levels.
Main Results:
- A statistically significant reduction in both systolic and diastolic blood pressure was observed.
- No significant changes were noted in blood glucose or fructosamine levels.
- Insulin secretion, assessed via c-peptide, remained unmodified by captopril treatment.
Conclusions:
- Captopril is a safe and effective antihypertensive agent for elderly diabetic patients, even those with secondary failure and unstable metabolic control.
- Unlike other common antihypertensives, captopril does not negatively impact glucose metabolism or insulin secretion.
- Captopril offers a valuable therapeutic option for managing hypertension in complex diabetic patient populations.
Abstract:
In elderly patients diabetes and hypertension play an important and synergistic role in the development of cardiovascular complications. For this reason therapy must reduce blood pressure without compromising blood glucose control. We investigated the question of whether captopril, an angiotensin converting enzyme inhibitor, can be used without interference to glucose metabolism in diabetics with secondary failure. Ten elderly hypertensive diabetics (diastolic blood pressure greater than 95 mmHg), maintained in good metabolic control using oral hypoglycaemic agents and insulin, were studied before and after 30 days of captopril at 100 mg/day. We measured the following parameters: blood pressure, heart rate, fructosamine and a daily profile for blood glucose and c-peptide. There was a statistically significant reduction in systolic and diastolic blood pressure. No difference was observed in the levels of blood glucose and fructosamine. Insulin secretion as determined by c-peptide levels was not modified, in contrast with findings reported for the use of beta-blockers, diuretics or nifedipine. It seems that captopril is useful and without side effects, even in secondary-failure diabetic patients characterized by unstable metabolic control.