EFFECT OF FOSINOPRIL ON CARDIAC AND METABOLIC PARAMETERS IN PATIENTS WITH NIDDM

OBJECTIVE - To determine whether the angiotensin-converting enzyme (AC E) inhibitor fosinopril can favorably alter cardiac function in non-in sulin-dependent diabetes mellitus (NIDDM) patients who have either nor mal blood pressure (BP) or mild, untreated hypertension. RESEARCH DESI GN AND METHODS - Fifty-five NIDDM subjects with normal BP or mild, unt reated hypertension were randomized to treatment with the ACE-inhibito r fosinopril or placebo for 6 months in a randomized, double-blind tri al to determine the effect of fosinopril on echocardiographic measurem ents. RESULTS - Left ventricular mass index (LVMI) fell by 6.5 +/- 4.7 % (mean +/- SD) with fosinopril and increased by 8.6 +/- 3.5% during p lacebo treatment (P < 0.02), and isovolumic relaxation time improved s ignificantly in those with elevated baseline levels (P = 0.02). Systol ic BP fell significantly, but this did not correlate with the change i n LVMI, suggesting a possible direct action of fosinopril on the heart . CONCLUSIONS - Fosinopril appears to have significant cardiac benefit s in patients with NIDDM who have normal or mildly elevated BP. These benefits are achieved without adversely affecting renal status and wit hout impairing metabolic control of diabetes.