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Effects of ACE inhibition and AT1-receptor antagonism on endothelial function and insulin sensitivity in essential hypertensive patients.
J Renin Angiotensin Aldosterone Syst. 2003 Sep; 4(3):197-203.JR

Abstract

OBJECTIVE

Disturbed endothelial function is closely associated with hyperinsulinaemia and insulin resistance in essential hypertension. The aims of this study were: 1) to evaluate whether the two alternative drugs, angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (Ang II) antagonists, had comparable effects on glucose metabolism and endothelial function. 2) to determine whether they improve endothelial dysfunction through modulating insulin resistance and oxidative stress.

STUDY DESIGN AND METHODS

Essential hypertensive patients were randomised into two groups: Twelve (nine patients in final analysis) patients were given enalapril (enalapril group), and twelve (nine patients in final analysis) were given losartan (losartan group). Twelve sex- and age-matched normotensive volunteers were included as controls. Before and after six months of treatment, endothelial function, insulin sensitivity and lipid peroxidation (TBARs) and NO metabolites (NOx) were evaluated.

RESULTS

Endothelial function, measured as flow mediated dilatation (FMD), was improved in both of the treatment groups (p=0.0001). Calculated insulin sensitivity index also improved in the enalapril-treated group (p=0.05) but not in the losartan-treated group, compared with baseline levels. TBARS values decreased significantly in the enalapril group compared with baseline levels (p<0.001). FMD was positively correlated with insulin sensitivity index (r=0.32, p<0.05) and NOx levels (r=0.39, p=0.01) and negatively correlated with TBARS levels (r=-0.53, p=0.0002) in hypertensive patients.

CONCLUSION

Inhibition of the renin-angiotensin system, either with ACE inhibitors or AT(1)-receptor blockers improves endothelial dysfunction. ACE inhibition has prominent effects on improving insulin sensitivity and decreasing oxidative stress in essential hypertensive patients.

Authors+Show Affiliations

Section of Endocrinology and Metabolism, Marmara University, Istanbul, 34660, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

14608527

Citation

Yavuz, Dilek, et al. "Effects of ACE Inhibition and AT1-receptor Antagonism On Endothelial Function and Insulin Sensitivity in Essential Hypertensive Patients." Journal of the Renin-angiotensin-aldosterone System : JRAAS, vol. 4, no. 3, 2003, pp. 197-203.
Yavuz D, Koç M, Toprak A, et al. Effects of ACE inhibition and AT1-receptor antagonism on endothelial function and insulin sensitivity in essential hypertensive patients. J Renin Angiotensin Aldosterone Syst. 2003;4(3):197-203.
Yavuz, D., Koç, M., Toprak, A., Akpinar, I., Velioğlu, A., Deyneli, O., Haklar, G., & Akalin, S. (2003). Effects of ACE inhibition and AT1-receptor antagonism on endothelial function and insulin sensitivity in essential hypertensive patients. Journal of the Renin-angiotensin-aldosterone System : JRAAS, 4(3), 197-203.
Yavuz D, et al. Effects of ACE Inhibition and AT1-receptor Antagonism On Endothelial Function and Insulin Sensitivity in Essential Hypertensive Patients. J Renin Angiotensin Aldosterone Syst. 2003;4(3):197-203. PubMed PMID: 14608527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of ACE inhibition and AT1-receptor antagonism on endothelial function and insulin sensitivity in essential hypertensive patients. AU - Yavuz,Dilek, AU - Koç,Mehmet, AU - Toprak,Ahmet, AU - Akpinar,Ihsan, AU - Velioğlu,Ayliz, AU - Deyneli,Oguzhan, AU - Haklar,Goncagül, AU - Akalin,Sema, PY - 2003/11/11/pubmed PY - 2003/12/31/medline PY - 2003/11/11/entrez SP - 197 EP - 203 JF - Journal of the renin-angiotensin-aldosterone system : JRAAS JO - J Renin Angiotensin Aldosterone Syst VL - 4 IS - 3 N2 - OBJECTIVE: Disturbed endothelial function is closely associated with hyperinsulinaemia and insulin resistance in essential hypertension. The aims of this study were: 1) to evaluate whether the two alternative drugs, angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (Ang II) antagonists, had comparable effects on glucose metabolism and endothelial function. 2) to determine whether they improve endothelial dysfunction through modulating insulin resistance and oxidative stress. STUDY DESIGN AND METHODS: Essential hypertensive patients were randomised into two groups: Twelve (nine patients in final analysis) patients were given enalapril (enalapril group), and twelve (nine patients in final analysis) were given losartan (losartan group). Twelve sex- and age-matched normotensive volunteers were included as controls. Before and after six months of treatment, endothelial function, insulin sensitivity and lipid peroxidation (TBARs) and NO metabolites (NOx) were evaluated. RESULTS: Endothelial function, measured as flow mediated dilatation (FMD), was improved in both of the treatment groups (p=0.0001). Calculated insulin sensitivity index also improved in the enalapril-treated group (p=0.05) but not in the losartan-treated group, compared with baseline levels. TBARS values decreased significantly in the enalapril group compared with baseline levels (p<0.001). FMD was positively correlated with insulin sensitivity index (r=0.32, p<0.05) and NOx levels (r=0.39, p=0.01) and negatively correlated with TBARS levels (r=-0.53, p=0.0002) in hypertensive patients. CONCLUSION: Inhibition of the renin-angiotensin system, either with ACE inhibitors or AT(1)-receptor blockers improves endothelial dysfunction. ACE inhibition has prominent effects on improving insulin sensitivity and decreasing oxidative stress in essential hypertensive patients. SN - 1470-3203 UR - https://www.unboundmedicine.com/medline/citation/14608527/Effects_of_ACE_inhibition_and_AT1_receptor_antagonism_on_endothelial_function_and_insulin_sensitivity_in_essential_hypertensive_patients_ L2 - https://journals.sagepub.com/doi/10.3317/jraas.2003.032?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -