| Effect of angiotensin receptor blockade on insulin sensitivity and endothelial function in abdominally obese hypertensive patients with impaired fasting glucose. | |
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MedLine Citation:
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PMID: 21861845 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AngII (angiotensin II) may contribute to cardiovascular risk in obesity via adverse effects on insulin sensitivity and endothelial function. In the present study, we examined the effects of ARB (angiotensin receptor blocker) therapy (losartan, 100 mg/day) on insulin sensitivity and endothelial function in 53 subjects with stage I hypertension, abdominal obesity and impaired fasting glucose. The study design was a randomized double-blinded parallel design placebo-controlled multi-centre trial of 8 weeks duration. We used the hyperinsulinaemic-euglycaemic clamp technique to measure insulin sensitivity (expressed as the 'M/I' value) and RH-PAT (reactive hyperaemia-peripheral arterial tonometry) to measure endothelial function. Additional measures included HOMA (homoeostasis model assessment)-B, an index of pancreatic β-cell function, and markers of inflammation [e.g. CRP (C-reactive protein)] and oxidative stress (e.g. F2-isoprostanes). ARB therapy did not alter insulin sensitivity [5.2 (2.7) pre-treatment and 4.6 (1.6) post-treatment] compared with placebo therapy [6.1 (2.9) pre-treatment and 5.3 (2.7) post-treatment; P value not significant], but did improve the HOMA-B compared with placebo therapy (P=0.05). ARB therapy also did not change endothelial function [RH-PAT, 2.15 (0.7) pre-treatment and 2.11 (0.7) post-treatment] compared with placebo therapy [RH-PAT, 1.81 (0.5) pre-treatment and 1.76 (0.7) post-treatment; P value not significant]. Markers of inflammation and oxidative stress were not significantly changed by ARB therapy. In conclusion, ARB therapy did not alter peripheral insulin sensitivity or endothelial function in this cohort of patients with essential hypertension, abdominal obesity and impaired fasting glucose, but did improve pancreatic β-cell function. |
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Authors:
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Todd S Perlstein; Robert R Henry; Kieren J Mather; Michael R Rickels; Nicola I Abate; Scott M Grundy; Yabing Mai; Jeanine B Albu; Jennifer B Marks; James L Pool; Mark A Creager |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical science (London, England : 1979) Volume: 122 ISSN: 1470-8736 ISO Abbreviation: Clin. Sci. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2011-10-27 Completed Date: 2011-12-19 Revised Date: 2012-01-05 |
Medline Journal Info:
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Nlm Unique ID: 7905731 Medline TA: Clin Sci (Lond) Country: England |
Other Details:
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Languages: eng Pagination: 193-202 Citation Subset: IM |
Affiliation:
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Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, U.S.A. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Angiotensin II Type 1 Receptor Blockers / pharmacology, therapeutic use* Blood Pressure / drug effects Creatinine / blood Double-Blind Method Endothelium, Vascular / drug effects Female Glucose Metabolism Disorders / complications, drug therapy* Heart Rate / drug effects Humans Hypertension / complications, drug therapy* Losartan / pharmacology, therapeutic use* Male Middle Aged Obesity, Abdominal / complications* Potassium / blood Vasodilation / drug effects* |
| Grant Support | |
ID/Acronym/Agency:
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K12 HL083786/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin II Type 1 Receptor Blockers; 114798-26-4/Losartan; 60-27-5/Creatinine; 7440-09-7/Potassium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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