Open AccessMetabolic and Antihypertensive Effects of Combined Angiotensin Receptor Blocker and Diuretic Therapy in Prediabetic Hypertensive Patients With the Cardiometabolic Syndrome
Author(s) -
Zappe Dion H.,
Sowers James R.,
Hsueh Willa A.,
Haffner Steven M.,
Deedwania Prakash C.,
Fonseca Vivian A.,
Keeling Lucy,
Sica Domenic A.
Publication year - 2008
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2008.00054.x
Subject(s) - valsartan , medicine , hydrochlorothiazide , endocrinology , blood pressure , metabolic syndrome , insulin resistance , triglyceride , thiazide , insulin , diabetes mellitus , pharmacology , cholesterol
Hypertensive patients with the cardiometabolic syndrome (CMS) are at increased risk for type 2 diabetes and cardiovascular disease. The authors examined effects of valsartan and hydrochlorothiazide (HCTZ) combined and alone on insulin sensitivity (using homeostasis model assessment–insulin resistance [HOMA‐IR]), and inflammatory/metabolic biomarkers in prediabetic hypertensive persons with CMS. Eligible patients entered 16‐week therapy with valsartan 320 mg/d ( n =189), HCTZ 25 mg/d ( n =190), or valsartan/HCTZ 320/25 mg/d ( n =187). At the end point, there were no statistically significant differences in HOMA‐IR among the 3 groups. HCTZ significantly increased hemoglobin A 1c and triglyceride concentrations and lowered serum potassium levels vs valsartan. HCTZ also increased plasma aldosterone and C‐reactive protein levels. Blood pressure reduction and blood pressure control rates were highest with valsartan/HCTZ. There were no differences between combination valsartan/HCTZ or monotherapies on a measure of insulin sensitivity; however, the negative metabolic effects of HCTZ (increase in triglyceride and hemoglobin A 1c values) were absent with valsartan/HCTZ, indicating an ameliorating effect of valsartan on these measures.