Issue 142 Item 4 Pioglitazone Benefits Non-Diabetics With Hypertension

It appears to lower diastolic blood pressure, improve glucose metabolism and may help prevent the development of diabetes and cardiovascular disease. The insulin sensitizer used to treat type 2 diabetes, pioglitazone (Actos; Takeda Pharmaceuticals), may have a role in non-diabetic patients with essential hypertension, results of a controlled trial indicate.

Dr. Thomas Konrad of the Institute for Metabolic Research in Frankfurt and a German team randomized 60 patients non-diabetic patients with arterial hypertension to pioglitazone (45 mg/day) or placebo for 16 weeks.

Compared with placebo, pioglitazone treatment was associated with improved glucose metabolism, as evidenced by increased insulin sensitivity (P = 0.022) and decreased insulin resistance (P < 0.001). Pioglitazone also led to greater decreases in both fasting insulin (P = 0.002) and fasting glucose (P = 0.004).

On the lipid front, pioglitazone but not placebo was associated with significant increases in HDL-cholesterol (P = 0.006) and significant decreases in apolipoprotein B (P = 0.035).

Body weight remained unchanged in both study arms. Mean systolic BP fell by 6.7 mmHg in the pioglitazone arm and by 3.1 mmHg in the placebo arm, a difference that was not significant. However, the difference in changes in diastolic BP between pioglitazone and placebo were significant at -7.9 and -1.8 mmHg, respectively.

“These changes would suggest improved glucose metabolism and a possible reduction in risk of cardiovascular disease with pioglitazone treatment in non-diabetic patients with arterial hypertension,” the team concludes.

It can be assumed that therapy with pioglitazone reduces systolic and diastolic blood pressure. J Clin Endocrinol Metab 2002;87:5503-5506.

Let your Patients Check Their Own A1c Levels. It will motivate to better control.

www.a1cnow.net