[Arterial hypertension in obese patients with heart hypertrophy. Effects of captopril on insulin sensitivity and growth hormone].
OBJECTIVE
To evaluate the effects of captopril (Cpt).on carbohydrate metabolism and growth hormone (GH) in adults hypertensive obese patients with normal (NGT) or impaired (IGT) glucose tolerance and left ventricular hypertrophy.


METHODS
Ten patients (53 +/- 8 years), 8 women and 2 men, white, body mass index (BMI) > or = 26kg/m2, left ventricular mass index (LVMI) > 135g/m2 in man and > 110g/m2 in woman, with diastolic blood pressure (DBP) 95-115mmHg after 3 weeks of placebo, were identified by oral glucose tolerance test (OGTT-75g) as either with NGT or IGT, and treated with Cpt 25mg t.i.d. for 8 weeks. At the 8 weeks, dosage was increased to 50mg b.i.d. if DBP > 90mmHg or the decrease of the DBP < 10%, during the next 8 weeks. OGTT and clonidine tests (0,04mg/kg) with determinations, every 30 minutes of glucose, insulin, and GH during 2 hours, were performed.


RESULTS
Cpt lowered SBP and DBP in the NGT group and IGT group. The LVMI and the left ventricular mass (LVM) decreased in the IGT group with no significant change in the NGT group. Cpt promoted in the IGT group decrease in the area under the curve (AUC) of glucose, and AUC of insulin, with increase of the AUC of the percent of the beta cell function, AUC of HC, and insulin sensitivity index with no significantly change in the NGT group.


CONCLUSIONS
Adults hypertensive obese patients with IGT had decreased significantly in mean fasting level of GH concentrations compared to age, race, and BMI matched hypertensive patients with NGT. Treatment with Cpt induced a significant increased of the GH, with improvement of the metabolism in patients with IGT.
Velasco-Cornejo
I F
IF
Faculdade de Medicina de Botucatu, UNESP.
Martin
L C
LC
Brandão-Neto
J
J
Marchioli
M
M
de Barros e Silva
M
M
Anthanázio-Heliodoro
R de C
Rde C
Franco RJ da
S
S
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002216:Captopril / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000188:drug therapy*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications*; D013997:Time Factors
D000959:Antihypertensive Agents; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D013006:Growth Hormone; D002216:Captopril
Hipertensão arterial em pacientes obesos com hipertrofia cardíaca. Efeitos do captopril sobre a sensibilidade à insulina e hormônio de crescimento.