Captopril does not improve insulin action in essential hypertension

Wiggam, M I; Hunter, SJ; Atkinson, A. B.; Cn, Ennis; Js, Henry; Jn, Browne; Sheridan, B.; Pm, Bell

doi:10.1097/00004872-199816110-00012

Cited by 25 publications

(14 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 This is in agreement with findings by Petrie et al, 7 whereas others have shown a beneficial impact. 6 ACE inhibitors are recommended first-line treatment for many patients, 26 and the combination of ACE inhibitor and calcium channel blocker now has the support of large-scale outcome trials.…”

Section: Discussionsupporting

confidence: 91%

“…In agreement with others, 6,7 we found that ACE inhibitors are at least neutral in effect on insulin action. 8 More than 1 agent is usually required to meet strict blood pressure targets, and we have also examined the effect of combination treatment on insulin action in essential hypertension. The combination of high-dose diuretic (bendroflumethiazide 5 mg) and ACE inhibitor compared with an ACE inhibitor alone reduced insulin sensitivity suggesting that low-dose diuretic should be used in combination with ACE inhibitor.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effects on Insulin Action of Adding Low-Dose Thiazide to Angiotensin-Converting Enzyme Inhibitor in Essential Hypertension

McHenry

Atkinson²,

Hunter³

et al. 2013

Hypertension

Self Cite

View full text Add to dashboard Cite

Abstract-Concern exists regarding adverse metabolic effects of antihypertensive agents. In the United States, diuretics are recommended first-line but additional agents, usually angiotensin-converting enzyme (ACE) inhibitors, are often required to meet blood pressure targets. We have previously shown that the combination of low-dose diuretic with an ACE inhibitor has detrimental effects on insulin action compared with ACE inhibitor alone in hypertensive type 2 diabetic patients. Our aim was to establish whether similar effects occur in nondiabetic hypertensive patients using this combination. A randomized doubleblind placebo-controlled crossover design was used. After a 6-week run-in, when regular antihypertensive medications were withdrawn and placebo substituted, patients received captopril 50 mg twice daily with either bendroflumethiazide 1.25 mg (CB) or placebo (CP) for 12 weeks with a 6-week wash-out between treatments. Insulin action was assessed by hyperinsulinemic euglycemic clamp after the 6-week run-in and at the end of each treatment period. There were no differences between treatments in fasting glucose or insulin concentrations. Glucose infusion rates required to maintain euglycemia were the same with each treatment (CP 22.1±2.

show abstract

Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Effects on Insulin Action of Adding Low-Dose Thiazide to Angiotensin-Converting Enzyme Inhibitor in Essential Hypertension

McHenry

Atkinson²,

Hunter³

et al. 2013

Hypertension

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, many studies have shown that ACE inhibition has no beneficial effects on insulin sensitivity and the development of diabetes (Table 1) [15][16][17][18][19][20][21][22][23][24]. Unfortunately, several investigations on this issue are based on uncontrolled study designs and surrogate markers of insulin sensitivity, and are potentially confounded by the use of additional medication.…”

Section: Introductionmentioning

confidence: 99%

Effect of short-term ACE inhibitor treatment on peripheral insulin sensitivity in obese insulin-resistant subjects

et al. 2006

View full text Add to dashboard Cite

• A submitted manuscript is the version of the article upon submission and before peer-review. There can be important differences between the submitted version and the official published version of record. People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website.• The final author version and the galley proof are versions of the publication after peer review.• The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal.If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement: www.umlib.nl/taverne-license Take down policyIf you believe that this document breaches copyright please contact us at:repository@maastrichtuniversity.nl providing details and we will investigate your claim. Abstract Aims/hypothesis This study was designed to investigate the effect of short-term ACE inhibitor treatment on insulin sensitivity and to examine possible underlying metabolic and haemodynamic effects in obese insulin-resistant subjects. Methods A randomised, double-blind placebo-controlled trial was performed in 18 obese insulin-resistant men (age, 53±2 years; BMI, 32.6±0.8 kg/m 2 ; homeostasis model assessment of insulin resistance, 5.6±0.5; systolic blood pressure [SBP], 140.8±3.2; diastolic blood pressure [DBP], 88.8±1.6 mmHg), who were free of any medication. The aim was to examine the effects of 2 weeks of ACE inhibitor treatment (ramipril, 5 mg/day) on insulin sensitivity, forearm blood flow, substrate fluxes across the forearm, whole-body substrate oxidation and intramuscular triacylglycerol (IMTG) content.

show abstract

“…5,6 Insulin-resistant states are often associated with hypertension, and the effects of antihypertensive drugs on insulin resistance have been highlighted. Accumulated data indicate that ACE inhibitors have either no adverse effect on glucose control or insulin sensitivity [7][8][9][10] or may even improve them. [11][12][13][14][15][16][17][18][19][20] The variability of results between studies may relate to differences in experimental design, the degree of glycemia or insulin resistance, potassium balance, and the dose or duration of ACE inhibitor treatment, among others.…”

mentioning

confidence: 99%

ACE Inhibitor Improves Insulin Resistance in Diabetic Mouse Via Bradykinin and NO

et al. 2002

View full text Add to dashboard Cite

Abstract-Improvement of insulin resistance by ACE inhibitors has been suggested; however, this mechanism has not been proved. We postulated that activation of the bradykinin-nitric oxide (NO) system by an ACE inhibitor enhances glucose uptake in peripheral tissues by means of an increase in translocation of glucose transporter 4 (GLUT4), resulting in improvement of insulin resistance. Administration of an ACE inhibitor, temocapril, significantly decreased plasma glucose and insulin concentrations in type 2 diabetic mouse KK-Ay. Mice treated with temocapril showed a smaller plasma glucose increase after glucose load. We demonstrated that temocapril treatment significantly enhanced 2-[ 3 H]-deoxy-D-glucose (2-DG) uptake in skeletal muscle but not in white adipose tissue. Administration of a bradykinin B2 receptor antagonist, Hoe140, or an NO synthase inhibitor, L-NAME, attenuated the enhanced glucose uptake by temocapril. Moreover, we observed that translocation of GLUT4 to the plasma membrane was significantly enhanced by temocapril treatment without influencing insulin receptor substrate-1 phosphorylation. In L6 skeletal muscle cells, 2-DG uptake was increased by temocaprilat, and Hoe140 inhibited this effect of temocaprilat but not that of insulin. These results suggest that temocapril would improve insulin resistance and glucose intolerance through increasing glucose uptake, especially in skeletal muscle at least in part through enhancement of the bradykinin-NO system and consequently GLUT4 translocation. Key Words: angiotensin-converting enzyme Ⅲ bradykinin Ⅲ glucose Ⅲ insulin resistance Ⅲ nitric oxide T he earliest defect in the development of type 2 diabetes is insulin resistance, 1,2 characterized by decreased glucose transport and metabolism in muscle and adipocytes. 3,4 Glucose is cleared from the bloodstream by a family of facilitative transporters (glucose transporters, GLUTs). The glucose transporter GLUT4 mediates insulin-stimulated glucose uptake in adipocytes and muscle by rapidly moving from intracellular storage sites to the plasma membrane. In insulinresistant states such as obesity and type 2 diabetes, GLUT4 expression is decreased in adipose tissue but preserved in muscle. 5,6 Insulin-resistant states are often associated with hypertension, and the effects of antihypertensive drugs on insulin resistance have been highlighted. Accumulated data indicate that ACE inhibitors have either no adverse effect on glucose control or insulin sensitivity 7-10 or may even improve them. [11][12][13][14][15][16][17][18][19][20] The variability of results between studies may relate to differences in experimental design, the degree of glycemia or insulin resistance, potassium balance, and the dose or duration of ACE inhibitor treatment, among others. The actions of ACE inhibitors are due in part to the decrease in angiotensin II formation and accumulation of kinins, and the resulting increase in nitric oxide (NO) production may also play a role.Kishi et al 21 proposed that bradykinin directly stimulates GLUT4 t...

show abstract

Captopril does not improve insulin action in essential hypertension

Abstract: Captopril therapy in uncomplicated essential hypertension has no effect on peripheral or hepatic insulin sensitivity.

Cited by 25 publications

References 49 publications

Effects on Insulin Action of Adding Low-Dose Thiazide to Angiotensin-Converting Enzyme Inhibitor in Essential Hypertension

Effects on Insulin Action of Adding Low-Dose Thiazide to Angiotensin-Converting Enzyme Inhibitor in Essential Hypertension

Effect of short-term ACE inhibitor treatment on peripheral insulin sensitivity in obese insulin-resistant subjects

ACE Inhibitor Improves Insulin Resistance in Diabetic Mouse Via Bradykinin and NO

Contact Info

Product

Resources

About