[Glucose tolerance test and insulin secretion in patients with essential hypertension. Effect of enalapril].
OBJECTIVE
To investigate the effects of enalapril upon glucose and insulin metabolism in patients with essential hypertension.


METHODS
After 4 weeks of washout and 2 weeks of placebo therapy, 10 hypertensive patients were treated with enalapril for 12-14 weeks. Intravenous glucose tolerance test (IVGTT) during 182 minutes was performed before and after treatment. Venous blood samples were drawn for glucose and insulin determinations.


RESULTS
Enalapril caused a significant fall on systolic (-19 +/- 3 mmHg) and diastolic (-10 +/- 2 mmHg) blood pressure. During IVGTT, enalapril induced a small decrease in the area under the curve of glucose (placebo 18,966 +/- 732.6 mg/dl.min and enalapril 17,575 +/- 916.1 mg/dl.min) associated with a small increase in the area under the curve of insulin (placebo 3,155 +/- 446.99 mU/ml.min and enalapril 3.577 +/- 393.92 mU/ml.min). A small rise in the disappearance rate of glucose (Kg) was also observed following enalapril (placebo 2.09 +/- 0.33 and enalapril 2.56 +/- 0.53). The insulin responsiveness to glucose increased significantly from 0.16 +/- 0.020 during placebo to 0.21 +/- 0.023 during enalapril. The insulin sensitivity remained unchanged (placebo 1.97 +/- 0.24 and enalapril 1.83 +/- 0.21).


CONCLUSIONS
In hypertensive patients, the treatment with enalapril induced a small increase (not significant) in glucose tolerance caused by a significant rise in insulin responsiveness to glucose since no modification in insulin sensitivity was observed.
Escola Paulista de Medicina, São Paulo.
F de A
Fde A
Neves
N F
NF
Mezzomo
N E
NE
Kohlmann
O
O
Kohlmann Júnior
M T
MT
Zanella
A B
AB
Ribeiro
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D004656:Enalapril
Tolerância à glicose e secreção de insulina em pacientes com hipertensão arterial essencial. Efeito do enalapril.