IMPROVEMENT IN METABOLIC RISK-FACTORS FOR CORONARY HEART-DISEASE ASSOCIATED WITH CILAZAPRIL TREATMENT

被引：26

作者：

SHIEH, SM

SHEU, WHH

SHEN, DDC

FUH, MMT

JENG, CY

JENG, JR

CHEN, YDI

REAVEN, GM

机构：

[1] Department of Internal Medicine and Clinical Research Center, Department of Medicine, Stanford University, Stanford, CA

[2] National Defense Medical Center, Taipei, 100

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1992年 / 5卷 / 08期

关键词：

ANGIOTENSIN CONVERTING ENZYME INHIBITOR; HIGH BLOOD PRESSURE; INSULIN; GLUCOSE; LIPOPROTEINS; HYDROCHLOROTHIAZIDE;

D O I：

10.1093/ajh/5.8.506

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Patients with hypertension tend to be glucose intolerant, hyperinsulinemic, and dyslipedemic. Since all of these changes increase risk of coronary heart disease (CHD), it is important to know what effect antihypertensive treatment has on these variables. The current open-labelled, uncontrolled study was initiated in order to extend our understanding of these issues. This study was performed in 19 patients with hypertension who were started on an angiotensin converting enzyme (ACE)-inhibitor, cilazapril, with hydrochlorothiazide (HC) added if needed to control blood pressure. Plasma glucose and insulin responses to oral glucose and lipid concentrations were measured before, 26, and 52 weeks after starting treatment. Patients treated with either cilazapril (n = 9) or cilazapril + HC (n = 10) did not differ in terms of original (mean +/- SEM) blood pressure (159 +/- 5/101 +/- 1 v 156 +/- 4/103 +/- 2 mm Hg), age (53 +/- 2 v 54 +/- 2 years), sex distribution (5M: 4F v 7M: 3F), or body mass index (24.4 +/- 0.5 nu 24.2 +/- 0.9 kg/M2) . Blood pressure was also similar after 26 (137 +/- 4/88 +/- 1 v 133 +/- 3/90 +/- 1 mm Hg) and 52 (137 +/- 4/87 +/- 1 v 134 +/- 4/89 +/- 2 mm Hg) weeks of treatment. Plasma glucose and insulin responses decreased by 8 +/- 3% (P < .05) and 25 +/- 9% (P < .002), respectively, in cilazapril-treated patients, but did not change in those treated with cilazapril plus HC. Plasma triglyceride levels also tended to be lower by 13 +/- 6% in those treated with cilazapril and higher in the cilazapril + HC-treated group by 15 +/- 10%. The metabolic changes were seen by 26 weeks and stayed constant the remainder of the year. In conclusion, blood pressure fell in cilazapril-treated patients, associated with improvements in glucose, insulin, and lipid metabolism that would reduce risk of CHD. These changes could not be demonstrated when HC was added to cilazapril in order to achieve better control of blood pressure. These data suggest that the metabolic effects of antihypertensive drugs vary as a function of class of drug, independently of changes in blood pressure.

引用

页码：506 / 510

页数：5

共 25 条

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