Document Detail


Effect of angiotensin receptor blockade on insulin sensitivity and endothelial function in abdominally obese hypertensive patients with impaired fasting glucose.
MedLine Citation:
PMID:  21861845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  122     ISSN:  1470-8736     ISO Abbreviation:  Clin. Sci.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2011-10-27     Completed Date:  2011-12-19     Revised Date:  2012-01-05    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  193-202     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, U.S.A.
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MeSH Terms
Descriptor/Qualifier:
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:
K12 HL083786/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
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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