INSULIN-RESISTANCE AND HYPERTENSION IN THE ELDERLY - OPTIMAL DRUG-THERAPY

Numerous trials have demonstrated the negative effects of some antihyp ertensive drugs upon glucose handling. Such findings seem particularly interesting in aged hypertensive patients who are also insulin resist ant and affected by physiological changes in the renal and cardiovascu lar systems. It appears that calcium channel blockers and angiotensin converting enzyme (ACE) inhibitors are the most appropriate drugs to l ower blood pressure in aged insulin-resistant hypertensive patients. A ll calcium channel blockers studied have displayed similar metabolic e ffects, while among the ACE inhibitors studied, lisinopril was associa ted with the best metabolic responses. beta-Blockers and thiazide diur etics have strong negative effects on glucose handling. Further studie s are needed in order to investigate the metabolic effects of alpha(1) -antagonists in aged patients with insulin resistance and hypertension .