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Rosiglitazone lowers resting and blood pressure response to exercise in men with type 2 diabetes: A 1‐year randomized study
Author(s) -
Piché MarieEve,
Laberge AnneSophie,
Brassard Patrice,
Arsenault Benoit J.,
Bertrand Olivier F.,
Després JeanPierre,
Costerousse Olivier,
Poirier Paul
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13293
Subject(s) - rosiglitazone , medicine , endocrinology , blood pressure , agonist , type 2 diabetes , insulin resistance , diastole , diabetes mellitus , insulin , receptor
Aims We aimed to determine the effect of 1‐year treatment with the insulin sensitizer peroxisome proliferator‐activated receptor (PPAR)‐γ agonist rosiglitazone on exercise capacity and blood pressure (BP) response to exercise in men with coronary artery disease (CAD) and type 2 diabetes (T2D). Materials and Methods A total of 116 men (age, 64 ± 7 years; body mass index, 30.0 ± 4.4 kg/m 2 ) with CAD and T2D were randomized to receive rosiglitazone or placebo for 1 year. Exercise capacity (VO 2peak ) and BP response to exercise were assessed with a maximal treadmill test, prior to the intervention and at 1‐year follow‐up. Exercise‐induced hypertension (EIH) was defined as maximal systolic BP ≥ 220 mm Hg and/or diastolic BP ≥ 100 mm Hg. Results PPAR‐γ agonist‐treated patients showed improvements in fasting glucose, HbA1c and insulin sensitivity (Homeostasis model assessment of insulin resistance [HOMA‐IR]) (all P < .05). Resting BPs, maximal exercise diastolic BP and resting rate‐pressure product (RPP) were all reduced in the PPAR‐γ agonist group ( P < .05). Maximal exercise duration was unchanged. T2D patients who displayed the greatest improvement in insulin sensitivity (HOMA‐IR) under PPAR‐γ agonist treatment experienced a greater reduction in exercise BP and RPP ( P < .05). The proportion of men with EIH decreased in the PPAR‐γ agonist group during follow‐up (39.00% ± 0.06% vs 21.00% ± 0.05%). In the subgroup with EIH that was treated with a PPAR‐γ agonist, resting and exercise diastolic BP, as well as resting RPP, were all reduced at 1‐year follow‐up ( P < .05). Conclusions The insulin sensitizer rosiglitazone has a beneficial effect on resting and BP response to exercise in men with CAD and T2D, especially in those with an exaggerated BP response to exercise.