Insulin resistance as an intermediary endpoint.
In three prospective cohort studies, treatment with beta-blockers and diuretics has been associated with an increased risk of diabetes developing. Prospective, randomized studies with antihypertensive drugs have demonstrated differences between different classes of drugs regarding effects on insulin sensitivity. Thus, treatment with beta-blockers or diuretics is associated with impairment in insulin sensitivity, whereas most modern calcium-channel blockers and angiotensin-converting enzyme (ACE) inhibitors are neutral. However, there are exceptions within the different classes. Captopril seems to differ from the other ACE inhibitors in that the result is an improvement of insulin sensitivity. In the Captopril Primary Preventive Project the effects on cardiovascular disease and diabetes of captopril-based and conventional treatment are compared. This study will hopefully give the answer to the question whether insulin resistance is a valid intermediary endpoint.
Lithell
H O
HO
Department of Geriatrics, Uppsala University, Sweden.
D000959:Antihypertensive Agents / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology*; D011379:Prognosis
D000959:Antihypertensive Agents