Effect of Valsartan Addition to Amlodipine on Insulin Sensitivity in Overweight-Obese Hypertensive Patients

Fogari, Roberto; Preti, Paola; Zoppi, Annalisa; Mugellini, Amedeo; Corradi, Luca; Lazzari, Pierangelo; Santoro, Tara; Derosa, Giuseppe

doi:10.2169/internalmedicine.47.1427

Cited by 24 publications

(26 citation statements)

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“…RAS blockade has been shown to improve insulin sensitivity in individuals with hypertension or glucometabolic disorders [7][8][9]. In line with these data, we found improved insulin sensitivity after 26 weeks VAL treatment compared with PLB.…”

Section: Discussionsupporting

confidence: 90%

“…In the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial, RAS blockade with ARB valsartan for 5 years resulted in a 14% reduction in the onset of T2DM in individuals with IGM [6]. The mechanisms by which ARBs lower T2DM risk have partly been attributed to improvements in peripheral insulin sensitivity [7][8][9]. One of the proposed mechanisms responsible includes ARB-induced haemodynamic changes, resulting in increased blood flow with increased glucose and insulin delivery to insulin-sensitive tissues [10].…”

Section: Introductionmentioning

confidence: 99%

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Valsartan-induced improvement in insulin sensitivity is not paralleled by changes in microvascular function in individuals with impaired glucose metabolism

Zijl

Serné

Goossens

et al. 2011

Journal of Hypertension

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Valsartan-induced improvement in insulin sensitivity is not paralleled by changes in microvascular function in individuals with impaired glucose metabolism

Zijl

Serné

Goossens

et al. 2011

Journal of Hypertension

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“…One of the underlying mechanisms may involve a positive effect of RAS blockers on insulin sensitivity (8). In part, these effects may be a result of hemodynamic changes, increasing skeletal-muscle blood flow, with augmented glucose and insulin delivery to insulin-sensitive tissues (4).…”

mentioning

confidence: 99%

Valsartan Improves β-Cell Function and Insulin Sensitivity in Subjects With Impaired Glucose Metabolism

et al. 2011

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OBJECTIVERecently, the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research Trial demonstrated that treatment with the angiotensin receptor blocker (ARB) valsartan for 5 years resulted in a relative reduction of 14% in the incidence of type 2 diabetes in subjects with impaired glucose metabolism (IGM). We investigated whether improvements in β-cell function and/or insulin sensitivity underlie these preventive effects of the ARB valsartan in the onset of type 2 diabetes.RESEARCH DESIGN AND METHODSIn this randomized controlled, double-blind, two-center study, the effects of 26 weeks of valsartan (320 mg daily; n = 40) or placebo (n = 39) on β-cell function and insulin sensitivity were assessed in subjects with impaired fasting glucose and/or impaired glucose tolerance, using a combined hyperinsulinemic-euglycemic and hyperglycemic clamp with subsequent arginine stimulation and a 2-h 75-g oral glucose tolerance test (OGTT). Treatment effects were analyzed using ANCOVA, adjusting for center, glucometabolic status, and sex.RESULTSValsartan increased first-phase (P = 0.028) and second-phase (P = 0.002) glucose-stimulated insulin secretion compared with placebo, whereas the enhanced arginine-stimulated insulin secretion was comparable between groups (P = 0.25). In addition, valsartan increased the OGTT-derived insulinogenic index (representing first-phase insulin secretion after an oral glucose load; P = 0.027). Clamp-derived insulin sensitivity was significantly increased with valsartan compared with placebo (P = 0.049). Valsartan treatment significantly decreased systolic and diastolic blood pressure compared with placebo (P < 0.001). BMI remained unchanged in both treatment groups (P = 0.89).CONCLUSIONSTwenty-six weeks of valsartan treatment increased glucose-stimulated insulin release and insulin sensitivity in normotensive subjects with IGM. These findings may partly explain the beneficial effects of valsartan in the reduced incidence of type 2 diabetes.

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“…In a study conducted in overweight-obese hypertensive patients valsartan/amlodipine combination improved insulin sensitivity significantly more than monotherapy with either components 78 . Another study demonstrated that, in the same type of population,despite their equivalent BP lowering effect, valsartan/amlodipine combination produced a significant enhancement of insulin sensitivity whereas irbesartan/hydrochlorothiazide (HCTZ) combination did not influence it 79 .…”

Section: Metabolic Properties Of Arb/ccb Combinationmentioning

confidence: 96%

Clinical benefits from combination therapy in the treatment of hypertension

Fogari

Zoppi

2010

Hipertensión y Riesgo Vascular

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Effect of Valsartan Addition to Amlodipine on Insulin Sensitivity in Overweight-Obese Hypertensive Patients

Abstract: Objective The aim of the study was to evaluate the effect of valsartan/amlodipine combination on insulin sensitivity in overweight-obese hypertensive patients. Methods

Cited by 24 publications

References 50 publications

Valsartan-induced improvement in insulin sensitivity is not paralleled by changes in microvascular function in individuals with impaired glucose metabolism

Valsartan-induced improvement in insulin sensitivity is not paralleled by changes in microvascular function in individuals with impaired glucose metabolism

Valsartan Improves β-Cell Function and Insulin Sensitivity in Subjects With Impaired Glucose Metabolism

Clinical benefits from combination therapy in the treatment of hypertension

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