Hormonal and metabolic effects of enalapril treatment in hypertensive subjects with NIDDM.
The effects of enalapril treatment on blood glucose, insulin, and C-peptide levels and effects on the renin-angiotensin aldosterone system were studied in 22 hypertensive patients with non-insulin-dependent diabetes. After a 4-wk run-in period during which all previous antihypertensive drugs were discontinued, treatment was commenced with one daily dose of 10 mg enalapril. The dose was adjusted upward at 3-wk intervals to a maximum of 40 mg daily. In 3 subjects, addition of a thiazide diuretic was required after 9 wk of treatment. At completion of run-in and after 9 and 13 wk of treatment, subjects had blood samples drawn after fasting and 2 h after a standardized 1.6-mJ mixed meal. Mean fasting blood glucose at the end of the run-in period was 8.3 +/- 0.5 mM and at study completion was 7.3 +/- 0.4 mM. Mean postprandial blood glucose was 10.8 +/- 1.0 mM before treatment and 9.8 +/- 0.7 mM at study completion. The changes in fasting and postprandial blood glucose levels were not significant (P = .06 and P = .15, respectively). There was no significant change in glycosylated hemoglobin levels. Fasting and meal-stimulated insulin and C-peptide levels were not altered by enalapril treatment. Treatment was associated with a sustained reduction in plasma angiotensin-converting enzyme activity, an increase in plasma renin activity, reduced plasma aldosterone levels, and significant reductions in supine, seated, and standing arterial blood pressures.(ABSTRACT TRUNCATED AT 250 WORDS)
Moore
M P
MP
Department of Endocrinology, Princess Margaret Hospital, Christchurch, New Zealand.
Elliott
T W
TW
Nicholls
M G
MG
D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000188:drug therapy*; D004656:Enalapril / Q000627:therapeutic use*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007328:Insulin / Q000097:blood; D007610:Kallikreins / Q000097:blood; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D004656:Enalapril; D007610:Kallikreins; D012083:Renin