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Item #11
Rosiglitazone Improves
Insulin Sensitivity, Lowers Blood Pressure in Hypertensives Without
Diabetes
Insulin
sensitizers may benefit nondiabetic patients with hypertension.
In
nondiabetic hypertensive patients, treatment with rosiglitazone
improves insulin sensitivity, reduces systolic and diastolic blood
pressure, and leads to improvements in several markers of
cardiovascular risk, according to a report in the January issue of
Diabetes Care.
First,
any patients on ACE inhibitors were switched to other hypertensives.
After 10 weeks, the patients were taken off antihypertensive
medication for a 2-week period at which point ambulatory blood
pressure was monitored and blood tests for cardiovascular risk factors
were completed. They also received a euglycemic-hyperinsulinemic clamp
with 6.6-[2H2] glucose infusion.
The
patients were then given 4 mg rosiglitazone b.i.d. and their usual
antihypertensive medication for 14 weeks. A 2-week period on
rosiglitazone only followed, after which the baseline tests were
repeated.
Between
the two tests, fasting plasma glucose did not change (83 mg/dL versus
82 mg/dL, p = 0.60), according to the investigators. However, fasting
insulin decreased from 16.1 to 12.5 U/mL (p < 0.001). There was an
increase in total glucose disposal during the clamp (p < 0.001),
"with no change in suppression of hepatic glucose output."
Mean
24-h systolic and diastolic blood pressure were significantly
decreased (-4 mm Hg and -5mm Hg, p < 0.02 and p < 0.0001,
respectively). The investigators observed a correlation between the
decline in systolic blood pressure and the improvement in insulin
sensitivity (p < 0.005).
"Markers
of cardiovascular risk including triglycerides, plasminogen activator
inhibitor-I, and C-reactive protein declined significantly in both
groups after rosiglitazone treatment," Dr. Raji and colleagues
note. "Both LDL and HDL cholesterol declined, resulting in no
change in the LDL-to-HDL ratio."
They
conclude that insulin sensitizers may benefit nondiabetic patients
with hypertension, even though the mechanism is not fully understood. Diabetes
Care 2003;26:172-178
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DID
YOU KNOW:
Native
Climate May Influence Your Ability to Burn Calories
Your
ancestors’ place of origin may determine how your body burns
calories, according to a recent study.
People whose relatives came from cold, arctic climates have
gene adaptations that allow their bodies to produce more heat while
burning calories. On the contrary, those whose ancestors came from
warmer climates tend to produce little extra heat and use calories
more efficiently. Researchers say that these adaptations are evidence
of natural selection in which genes evolved to account for
environmental stresses. Proceedings
of the National Academy of Sciences 2002;10.1073/pnas.0136972100
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