trandolapril and Glucose-Intolerance

We sought to test the hypothesis that a fixed-dose combination of trandolapril/verapamil-SR (T/V) is superior to a fixed-dose combination of losartan/hydrochlorothiazide (L/H) on glucose tolerance in hypertensive patients with impaired glucose tolerance (IGT).. A prospective, randomized, open-label, blinded-end points design was used to assess the effects of a T/V versus L/H combination in patients with IGT and hypertension (n = 240) followed for up to 1 year. Doses were titrated to a systolic blood pressure <130 mmHg. Primary outcome was change from baseline in a 2-h glucose on oral glucose tolerance test (OGTT) at study end (mean [+/-SD] at follow-up, 46.9 +/- 13.5 weeks). Secondary outcomes included changes in insulin sensitivity, office and 24-h ambulatory blood pressure, incidence of new-onset diabetes, lipids, and inflammatory markers. Data are expressed as means +/- SE unless otherwise noted.. Changes at study end were noted in 2-h OGTT glucose (T/V -0.21 +/- 0.36 vs. L/H +1.44 +/- 0.36 mmol/l; P < 0.001) and insulin level (-30.13 +/- 38.38 vs. +84.86 +/- 38.33 pmol/l, respectively; P = 0.025). Worsening of insulin resistance occurred by week 12 (T/V 0.000 +/- 0.001 vs. L/H -0.005 +/- 0.001; P = 0.016). A higher incidence of new-onset diabetes (T/V 11.0 vs. L/H 26.6%; P = 0.002) and HbA1c >7% (2.6 vs. 9.6%, respectively; P = 0.05) occurred at study end.. In patients with IGT, normal kidney function, and hypertension, the fixed-dose combination of T/V reduces the risk of new-onset diabetes compared with an L/H-based therapy.

Topics: Adult; Antihypertensive Agents; Blood Glucose; Body Mass Index; Body Size; Body Weight; Drug Therapy, Combination; Female; Glucose Intolerance; Glucose Tolerance Test; Humans; Hypertension; Indoles; Male; Metabolic Syndrome; Middle Aged; Patient Selection; Verapamil

The study was designed to evaluate effect of trandolapril, an ACE inhibitor, on platelet aggregation in patients with arterial hypertension and impaired glucose tolerance. The drug was given to 38 patients for 12 weeks. The key end points were dynamics of the blood lipid spectrum, lipid peroxidation in plasma and platelets, antioxidative protection of the blood's liquid medium and platelets, platelet aggregation. The data obtained were treated using Student's t-test. They show that trandolapril exerts positive effect on peroxidation syndrome and reduces platelet aggregation.

Topics: Angiotensin-Converting Enzyme Inhibitors; Glucose Intolerance; Hemostasis; Humans; Hypertension; Indoles; Platelet Aggregation