EFFECTS OF TRANDOLAPRIL ON INSULIN CONCENTRATIONS AND OTHER METABOLICVARIABLES IN HYPERTENSIVE PATIENTS

The effects of the angiotensin-converting enzyme inhibitor trandolapri l on blood pressure, insulin sensitivity, and other metabolic variable s were assessed in this open study of 45 patients (27 women and 18 men ; mean age, 53.1 +/- 14.0 years; mean body weight, 83.4 +/- 12.4 kg) w ith hypertension (blood pressure >140/90 mm Hg), Fasting and postprand ial serum insulin and plasma glucose concentrations were measured dail y before and after trandolapril administration (2 to 4 mg/d) for 12 we eks, Systolic and diastolic blood pressures and low-density Lipoprotei n cholesterol concentration were reduced significantly, Mean fasting i nsulin concentrations fell from 56.4 +/- 38.0 pmol/L to 42.4 +/- 28.0 pmol/L, and during an oral glucose tolerance test (OGTT) from 341.6 +/ - 305.0 pmol/L to 242.7 +/- 229.0 pmol/L at 2 hours, The ratio of mean fasting insulin to glucose fell from 0.7 +/- 0.4 to 0.5 +/- 0.4, and during OGTT the ratio fell from 3.3 +/- 2.0 to 2.6 +/- 1.7 between 1 a nd 2 hours, Total cholesterol decreased and high-density lipoprotein c holesterol increased, although neither change was significant, After t randolapril treatment, insulin and glucose concentrations improved, Th e lack of negative effects of trandolapril on metabolic variables may offer advantages not seen with other antihypertensive agents such as b eta-blockers and diuretics.