ENHANCEMENT OF INSULIN SENSITIVITY BY TROGLITAZONE LOWERS BLOOD-PRESSURE IN DIABETIC HYPERTENSIVES

The association of hypertension with insulin resistance has been repor ted. Troglitazone (CS-045) is a newly developed antidiabetic agent tha t enhances insulin sensitivity. Its antidiabetic effects have been con firmed in diabetic animals and patients. The present study was perform ed to evaluate whether the amelioration of hyperinsulinemia by troglit azone lowers blood pressure in essential hypertensives. Troglitazone w as administered orally to 18 outpatients with essential hypertension c omplicated by mild diabetes at a dose of 200 mg twice a day for 8 week s. Blood pressure was decreased from 164 +/- 3/94 +/- 2 mm Hg to 146 /- 3 (P < .001)/82 +/- 3 (P < .05) mm Hg at 8 weeks of the treatment p eriod. Pulse rate did not change. Pasting plasma glucose changed from 159 +/- 10 mg/dL to 144 +/- 14 mg/dL at 8 weeks (P < .05). Plasma insu lin (IRI) levels changes from 9.1 +/- 1.2 mu U/mL to 6.3 +/- 0.8 mu U/ mL at the endpoint of treatment (P < .1). Decrease in mean blood press ure from the control period to the endpoint of the treatment correlate d significantly with decrease in IRI (r = 0.59, P < .05). In summary, troglitazone treatment induces improvement in both glucose metabolism and blood pressure control in essential hypertensive patients with dia betes mellitus. These results suggest that insulin resistance or plasm a insulin level plays a role in the pathogenesis of essential hyperten sion.