Effects of pioglitazone in nondiabetic patients with arterial hypertension: a double-blind, placebo-controlled study.
Hypertension is often associated with insulin resistance, dyslipidemia and obesity, which indicate a prediabetic state and increased risk of cardiovascular disease. Pioglitazone treatment of patients with type 2 diabetes reduces insulin resistance and improves lipid profiles. The present double-blind placebo-controlled study is the first study to report effects of pioglitazone in non-diabetic patients with arterial hypertension. Following a one week run-in, 60 patients were randomized to receive either pioglitazone (45 mg/day) or placebo for 16 weeks. Insulin sensitivity (M-value) increased by 1.2 +/- 1.7 mg/min/kg with pioglitazone compared with 0.4 +/- 1.4 mg/min/kg (P = 0.022) with placebo. HOMA index was decreased (-22.5 +/- 45.8) by pioglitazone but not by placebo (+0.8 +/- 26.5; P < 0.001). Decreases in fasting insulin and glucose were significantly (P = 0.002 and P = 0.004, respectively) greater with pioglitazone than placebo. Body weight did not change significantly with either treatment. HDL-cholesterol was increased and apolipoprotein B was decreased to a significantly greater extent with pioglitazone. There was a significantly (P = 0.016) greater decrease from baseline in diastolic blood pressure with pioglitazone. These changes would suggest improved glucose metabolism and a possible reduction in risk of cardiovascular disease with pioglitazone treatment of non-diabetic patients with arterial hypertension.
Füllert
S
S
Medical Department I, J. W. Goethe University, Frankfurt, Germany.
Schneider
F
F
Haak
E
E
Rau
H
H
Badenhoop
K
K
Lübben
G
G
Usadel
K-H
KH
Konrad
T
T
D001055:Apolipoproteins B / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D004311:Double-Blind Method; D005215:Fasting / Q000097:blood; D005260:Female; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood / Q000502:physiology; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D010919:Placebos; D013844:Thiazoles / Q000627:therapeutic use*; D045162:Thiazolidinediones
D001055:Apolipoproteins B; D001786:Blood Glucose; D008076:Cholesterol, HDL; D007004:Hypoglycemic Agents; D007328:Insulin; D010919:Placebos; D013844:Thiazoles; D045162:Thiazolidinediones; D000077205:Pioglitazone