Treatment of the Hypertensive Diabetic: Focus on Calcium Channel Blockade

We undertook the present study to examine the effect of the angiotensin-converting enzyme inhibitor enalapril, the angiotensin II antagonist losartan, and calcium antagonist verapamil on systolic pressure and spontaneous blood glucose levels in rats from the Cohen-Rosenthal diabetic hypertensive strain. Genetic hypertension and diabetes developed in this strain after crossbreeding of Cohen diabetic and spontaneously hypertensive rats. The new rat strain was fed their usual copper-poor sucrose diet, which is essential for the development of this model, and for 4 weeks received either enalapril, losartan, or verapamil. Systolic pressure was reduced significantly compared with controls in all treated groups. Chronic treatment with enalapril or verapamil, but not with losartan, succeeded in lowering spontaneous blood glucose, indicating improved diabetic control. Data suggest that angiotensin-converting enzyme inhibition by enalapril, but not angiotensin II antagonism by losartan, can improve glucose metabolism in addition to its hypotensive effect in a genetic diabetic hypertensive rat strain. This confirms that the drop in glucose with converting enzyme inhibition is highly dependent on bradykinin accumulation. Data further suggest that calcium channel blockade by verapamil can also improve glucose metabolism. The question remains whether the reduction in glucose by verapamil was a result of inhibition of glucogenesis.

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Effects of Enalapril, Losartan, and Verapamil on Blood Pressure and Glucose Metabolism in the Cohen-Rosenthal Diabetic Hypertensive Rat

Rosenthal

Erlich

Rosenmann

et al. 1997

Hypertension

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Treatment of the Hypertensive Diabetic: Focus on Calcium Channel Blockade

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Effects of Enalapril, Losartan, and Verapamil on Blood Pressure and Glucose Metabolism in the Cohen-Rosenthal Diabetic Hypertensive Rat

Effects of Enalapril, Losartan, and Verapamil on Blood Pressure and Glucose Metabolism in the Cohen-Rosenthal Diabetic Hypertensive Rat

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