It has been suggested that the metabolic side effects of antihypertensive drugs are responsible for their failure to reduce cardiovascular morbidity in patients with hypertension. Therefore, in 50 patients with essential hypertension, we performed a randomized, double-blind, crossover study comparing the effects of carbohydrate and lipid metabolism of captopril (mean [+/- SD] dose, 81 +/- 24 mg per day) and hydrochlorothiazide (40 +/- 12 mg per day) over two four-month treatment periods. Captopril increased the insulin-mediated disposal of glucose, as compared with placebo, from 5.7 +/- 2.4 to 6.3 +/- 2.5 mg per kilogram of body weight per minute (P less than 0.05), whereas hydrochlorothiazide caused a decrease from 6.4 +/- 2.0 to 5.7 +/- 1.9 (P less than 0.01). Captopril had no effect on the basal insulin concentration, but it decreased the late (30- to 90-minute) insulin response to glucose and increased the early (2- to 6-minute) insulin peak. Hydrochlorothiazide increased the basal insulin concentration and the late insulin response to glucose. These findings may be explained by an increase in insulin sensitivity with captopril and a decrease with hydrochlorothiazide. Little or no change was seen in serum lipid or lipoprotein levels during treatment with captopril, whereas hydrochlorothiazide caused significant increases in serum total (5 percent) and low-density lipoprotein (6 percent) cholesterol levels and total (15 percent) and very-low-density lipoprotein (25 percent) triglyceride levels, as compared with placebo (P less than 0.01 for all comparisons). We conclude that hydrochlorothiazide for the treatment of essential hypertension has adverse effects on glucose and lipid metabolism. It is possible, but not proved in this study, that these changes may contribute to the risk for diabetes mellitus and coronary heart disease. In contrast, captopril appears to have beneficial or no effects on glucose and lipid metabolism.
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Department of Geriatrics, Uppsala University, Sweden.
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[Abstract][Full Text]
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(2003). A Comparison of Outcomes with Angiotensin-Converting-Enzyme Inhibitors and Diuretics for Hypertension in the Elderly. NEJM
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[Abstract][Full Text]
Ellison, D. H.
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[Full Text]
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5: A43-A48
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Dengel, D. R., Brown, M. D., Ferrell, R. E., Reynolds, T. H. IV, Supiano, M. A.
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[Abstract][Full Text]
Refsgaard, J., Thomsen, C., Andreasen, F., Gotzsche, O.
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[Abstract][Full Text]
Sechi, L. A., Catena, C., Zingaro, L., Melis, A., De Marchi, S.
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[Abstract][Full Text]
Niskanen, L., Hedner, T., Hansson, L., Lanke, J., Niklason, A.
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[Abstract][Full Text]
Duka, I., Shenouda, S., Johns, C., Kintsurashvili, E., Gavras, I., Gavras, H.
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38: 1355-1360
[Abstract][Full Text]
Grandi, A. M., Zanzi, P., Broggi, R., Fachinetti, A., Guasti, L., Ceriani, L., Venco, A.
(2001). Longitudinal Changes of Insulin Sensitivity in Essential Hypertension: Influence of Blood Pressure Control and Familial Predisposition to Hypertension. J. Clin. Endocrinol. Metab.
86: 3027-3031
[Abstract][Full Text]
Formiga, F, Meco, J F, Pinto, X, Jacob, J, Moga, I, Pujol, R
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10: 359-363
[Abstract]
Lindblad, U., Langer, R. D., Wingard, D. L., Thomas, R. G., Barrett-Connor, E. L.
(2001). Metabolic Syndrome and Ischemic Heart Disease in Elderly Men and Women. Am J Epidemiol
153: 481-489
[Abstract][Full Text]
Perticone, F., Ceravolo, R., Iacopino, S., Cloro, C., Ventura, G., Maio, R., Gulletta, E., Perrotti, N., Mattioli, P. L.
(2001). Relationship between Angiotensin-Converting Enzyme Gene Polymorphism and Insulin Resistance in Never-Treated Hypertensive Patients. J. Clin. Endocrinol. Metab.
86: 172-178
[Abstract][Full Text]
Kudoh, A., Matsuki, A.
(2000). Effects of Angiotensin-Converting Enzyme Inhibitors on Glucose Uptake. Hypertension
36: 239-244
[Abstract][Full Text]
Blumenthal, J. A., Sherwood, A., Gullette, E. C. D., Babyak, M., Waugh, R., Georgiades, A., Craighead, L. W., Tweedy, D., Feinglos, M., Appelbaum, M., Hayano, J., Hinderliter, A.
(2000). Exercise and Weight Loss Reduce Blood Pressure in Men and Women With Mild Hypertension: Effects on Cardiovascular, Metabolic, and Hemodynamic Functioning. Arch Intern Med
160: 1947-1958
[Abstract][Full Text]
Moser, M.
(1999). National Recommendations for the Pharmacological Treatment of Hypertension: Should They Be Revised?. Arch Intern Med
159: 1403-1406
[Full Text]
CHAN;, N N, PIEDROLA, G
(1999). ACE inhibitors and insulin sensitivity. Postgrad. Med. J.
75: 445a-445
[Full Text]
Steen, M. S., Foianini, K. R., Youngblood, E. B., Kinnick, T. R., Jacob, S., Henriksen, E. J.
(1999). Interactions of exercise training and ACE inhibition on insulin action in obese Zucker rats. J. Appl. Physiol.
86: 2044-2051
[Abstract][Full Text]
Gaudreault, N., Santure, M., Nadeau, A., Bachelard, H.
(1999). Isradipine and insulin sensitivity in hypertensive rats. Am. J. Physiol. Endocrinol. Metab.
276: E1038-E1048
[Abstract][Full Text]
Paternostro, G., Pagano, D., Gnecchi-Ruscone, T., Bonser, R. S, Camici, P. G
(1999). Insulin resistance in patients with cardiac hypertrophy. Cardiovasc Res
42: 246-253
[Abstract][Full Text]
Ernsberger, P., Ishizuka, T., Liu, S., Farrell, C. J., Bedol, D., Koletsky, R. J., Friedman, J. E.
(1999). Mechanisms of Antihyperglycemic Effects of Moxonidine in the Obese Spontaneously Hypertensive Koletsky Rat (SHROB). J. Pharmacol. Exp. Ther.
288: 139-147
[Abstract][Full Text]
Piédrola, G., Novo, E., Serrano-Gotarredona, J., de Teresa, M. L., García-Robles, R.
(1999). Evolution of insulin resistance in coronary artery disease patients on four different pharmacological therapies. Postgrad. Med. J.
75: 27-31
[Abstract][Full Text]
Kamide, K., Hori, M. T., Zhu, J.-H., Barrett, J. D., Eggena, P., Tuck, M. L.
(1998). Insulin-Mediated Growth in Aortic Smooth Muscle and the Vascular Renin-Angiotensin System. Hypertension
32: 482-487
[Abstract][Full Text]
Moser, M.
(1998). Why Are Physicians Not Prescribing Diuretics More Frequently in the Management of Hypertension?. JAMA
279: 1813-1816
[Abstract][Full Text]
Petrie, J. R., Morris, A. D., Minamisawa, K., Hilditch, T. E., Elliott, H. L., Small, M., MC Connell, J.
(1998). Dietary Sodium Restriction Impairs Insulin Sensitivity in Noninsulin-Dependent Diabetes Mellitus. J. Clin. Endocrinol. Metab.
83: 1552-1557
[Abstract][Full Text]
Powers, D. R., Wallin, J. D.
(1998). End-stage Renal Disease in Specific Ethnic and Racial Groups: Risk Factors and Benefits of Antihypertensive Therapy. Arch Intern Med
158: 793-800
[Abstract][Full Text]
Uehara, Y., Hirawa, N., Numabe, A., Kawabata, Y., Nagoshi, H., Negoro, H., Fujiwara, S., Gomi, T., Ikeda, T., Goto, A., Omata, M.
(1998). Angiotensin-Converting Enzyme Inhibition Delays Onset of Glucosuria With Regression of Renal Injuries in Genetic Rat Model of Non-Insulin-Dependent Diabetes Mellitus. J CARDIOVASC PHARMACOL THER
3: 327-335
[Abstract]
Spangler, J. G., Bell, R. A., Summerson, J. H., Konen, J. C.
(1998). Hyperinsulinemia in Hypertension: Associations With Race, Abdominal Obesity, and Hyperlipidemia. Arch Fam Med
7: 53-56
[Abstract][Full Text]
O'Callaghan, C. J., Komersova, K., Louis, W. J.
(1998). Acute Effects of Blood Pressure Elevation on Insulin Clearance in Normotensive Healthy Subjects. Hypertension
31: 104-109
[Abstract][Full Text]
Dagogo-Jack, S., Santiago, J. V.
(1997). Pathophysiology of Type 2 Diabetes and Modes of Action of Therapeutic Interventions. Arch Intern Med
157: 1802-1817
[Abstract]
Reisin, E., Weir, M. R., Falkner, B., Hutchinson, H. G., Anzalone, D. A., Hypertension, M. L. T. f. t. T. i. O. P. W.
(1997). Lisinopril Versus Hydrochlorothiazide in Obese Hypertensive Patients : A Multicenter Placebo-Controlled Trial. Hypertension
30: 140-145
[Abstract][Full Text]
Rosenthal, T., Erlich, Y., Rosenmann, E., Cohen, A.
(1997). Effects of Enalapril, Losartan, and Verapamil on Blood Pressure and Glucose Metabolism in the Cohen-Rosenthal Diabetic Hypertensive Rat. Hypertension
29: 1260-1264
[Abstract][Full Text]
Chan, P., Tomlinson, B., Lee, C.-B., Pan, W.-H., Lee, Y.-S.
(1996). Beneficial Effects of Pravastatin on Fasting Hyperinsulinemia in Elderly Hypertensive Hypercholesterolemic Subjects. Hypertension
28: 647-651
[Abstract][Full Text]
Jamerson, K. A., Nesbitt, S. D., Amerena, J. V., Grant, E., Julius, S.
(1996). Angiotensin Mediates Forearm Glucose Uptake by Hemodynamic Rather Than Direct Effects. Hypertension
27: 854-858
[Abstract][Full Text]
Egan, B. M., Hennes, M. M.I., Stepniakowski, K. T., O'Shaughnessy, I. M., Kissebah, A. H., Goodfriend, T. L.
(1996). Obesity Hypertension Is Related More to Insulin's Fatty Acid Than Glucose Action. Hypertension
27: 723-728
[Abstract][Full Text]
Navarro-Cid, J., Maeso, R., Perez-Vizcaino, F., Cachofeiro, V., Ruilope, L. M., Tamargo, J., Lahera, V.
(1995). Effects of Losartan on Blood Pressure, Metabolic Alterations, and Vascular Reactivity in the Fructose-Induced Hypertensive Rat. Hypertension
26: 1074-1078
[Abstract][Full Text]
Kokkinos, P. F., Narayan, P., Colleran, J. A., Pittaras, A., Notargiacomo, A., Reda, D., Papademetriou, V.
(1995). Effects of Regular Exercise on Blood Pressure and Left Ventricular Hypertrophy in African-American Men with Severe Hypertension. NEJM
333: 1462-1467
[Abstract][Full Text]
Kohlman, O. Jr, de Assis Rocha Neves, F., Ginoza, M., Tavares, A., Cezaretti, M. L., Zanella, M. T., Ribeiro, A. B., Gavras, I., Gavras, H.
(1995). Role of Bradykinin in Insulin Sensitivity and Blood Pressure Regulation During Hyperinsulinemia. Hypertension
25: 1003-1007
[Abstract][Full Text]
Monane, M., Glynn, R. J., Gurwitz, J. H., Bohn, R. L., Levin, R., Avorn, J.
(1995). Trends in Medication Choices for Hypertension in the Elderly : The Decline of the Thiazides. Hypertension
25: 1045-1051
[Abstract][Full Text]
Manolio, T. A., Cutler, J. A., Furberg, C. D., Psaty, B. M., Whelton, P. K., Applegate, W. B.
(1995). Trends in Pharmacologic Management of Hypertension in the United States. Arch Intern Med
155: 829-837
[Abstract]
(1994). Can the Cost of Care Be Contained and Quality of Care Maintained in the Management of Hypertension?. Arch Intern Med
154: 1665-1672
[Abstract]
Harper, R, Ennis, C N, Sheridan, B, Atkinson, A B, Johnston, G D, Bell, P M
(1994). Effects of low dose versus conventional dose thiazide diuretic on insulin action in essential hypertension. BMJ
309: 226-230
[Abstract][Full Text]
Goldstein, A. O., Carey, T. S., Levis, D., Madson, S., Bernstein, J.
(1994). Variations in Hypertension Control in Indigent Rural Primary Care Clinics in North Carolina. Arch Fam Med
3: 514-519
[Abstract]
Fournier, A., Lalau, J.D., Lopez, A., Marantz, P. R., Parving, H.-H., Lewis, E. J., Bain, R. P.
(1994). The Effect of Angiotensin-Converting-Enzyme Inhibition on Diabetic Nephropathy. NEJM
330: 937-938
[Full Text]
Materson, B. J., Preston, R. A.
(1994). Angiotensin-Converting Enzyme Inhibitors in Hypertension: A Dozen Years of Experience. Arch Intern Med
154: 513-523
[Abstract]
(1994). Antihypertensive Therapy in a Patient With Gout and Asthma. JAMA
271: 555-555
Daly, A.
(1994). Diabesity: The Deadly Pentad Disease. The Diabetes Educator
20: 156-162
Psaty, B. M., Savage, P. J., Tell, G. S., Polak, J. F., Hirsch, C. H., Gardin, J. M., McDonald, R. H. Jr
(1993). Temporal Patterns of Antihypertensive Medication Use Among Elderly Patients: The Cardiovascular Health Study. JAMA
270: 1837-1841
[Abstract]
Slataper, R., Vicknair, N., Sadler, R., Bakris, G. L.
(1993). Comparative Effects of Different Antihypertensive Treatments on Progression of Diabetic Renal Disease. Arch Intern Med
153: 973-980
[Abstract]
Hebert, P. R., Moser, M., Mayer, J., Glynn, R. J., Hennekens, C. H.
(1993). Recent Evidence on Drug Therapy of Mild to Moderate Hypertension and Decreased Risk of Coronary Heart Disease. Arch Intern Med
153: 578-581
[Abstract]
Julius, S.
(1993). Insulin, Insulin Resistance, and Blood Pressure Elevation. Arch Intern Med
153: 290-291
[Abstract]
Alderman, M. H.
(1992). Which Antihypertensive Drugs First-- and Why!. JAMA
267: 2786-2787
[Abstract]
Khoury, A. F., Kaplan, N. M.
(1991). {alpha}-Blocker Therapy of Hypertension: An Unfulfilled Promise. JAMA
266: 394-398
[Abstract]
Moser, M., Hebert, P., Hennekens, C. H.
(1991). An Overview of the Meta-analyses of the Hypertension Treatment Trials. Arch Intern Med
151: 1277-1279
[Abstract]
Warram, J. H., Laffel, L. M. B., Valsania, P., Christlieb, A. R., Krolewski, A. S.
(1991). Excess Mortality Associated With Diuretic Therapy in Diabetes Mellitus. Arch Intern Med
151: 1350-1356
[Abstract]
Friedman, R. B., Katt, J. A.
(1991). Cost-Benefit Issues in the Practice of Internal Medicine. Arch Intern Med
151: 1165-1168
[Abstract]
Gurwitz, J. H., Avorn, J.
(1991). The Ambiguous Relation between Aging and Adverse Drug Reactions. ANN INTERN MED
114: 956-966
[Abstract]
Working Group on Management of Patients with Hyper,
(1991). National Education Programs Working Group Report on the Management of Patients with Hypertension and High Blood Cholesterol. ANN INTERN MED
114: 224-237
[Abstract]
Moser, M., Blaufox, M. D., Freis, E., Gifford, R. W. Jr, Kirkendall, W., Langford, H., Shapiro, A., Sheps, S.
(1991). Who Really Determines Your Patients' Prescriptions?. JAMA
265: 498-500
[Abstract]
Hartl, W. H., Wolfe, R. R.
(1990). Review: The Phospholipid/Arachidonic Acid Second Messenger System: Its Possible Role in Physiology and Pathophysiology of Metabolism. JPEN J Parenter Enteral Nutr
14: 416-427
[Abstract]
Christlieb, A. R.
(1990). Treatment Selection Considerations for the Hypertensive Diabetic Patient: A. Richard Christlieb, MD. Arch Intern Med
150: 1167-1174
[Abstract]
Kochar, M. S., Landry, K. M., Ristow, S. M.
(1990). Effects of Reduction in Dose and Discontinuation of Hydrochlorothiazide in Patients With Controlled Essential Hypertension. Arch Intern Med
150: 1009-1011
[Abstract]
Littenberg, B., Garber, A. M., Sox, H. C. Jr.
(1990). Screening for Hypertension. ANN INTERN MED
112: 192-202
[Abstract]
(1989). CAPTOPRIL HAS FEWER ADVERSE EFFECTS ON GLUCOSE AND LIPID METABOLISM THAN THIAZIDES. JWatch General
1989: 4-4
[Full Text]
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