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Titolo:
Vasodilatory effects of troglitazone improve blood pressure at rest and during mental stress in type 2 diabetes mellitus
Autore:
Sung, BH; Izzo, JL; Dandona, P; Wilson, MF;
Indirizzi:
Millard Fillmore Hosp, Dept Med, CGF, Buffalo, NY 14209 USA Millard Fillmore Hosp Buffalo NY USA 14209 ed, CGF, Buffalo, NY 14209 USA SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA SUNY Buffalo Buffalo NY USA14260 uffalo, Dept Med, Buffalo, NY 14260 USA
Titolo Testata:
HYPERTENSION
fascicolo: 1, volume: 34, anno: 1999,
pagine: 83 - 88
SICI:
0194-911X(199907)34:1<83:VEOTIB>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
NITRIC-OXIDE PRODUCTION; INSULIN SENSITIVITY; CARDIOVASCULAR REACTIVITY; GLUCOSE-TOLERANCE; SMOOTH-MUSCLE; HYPERTENSION; MORTALITY; DISEASE; NIDDM; OBESE;
Keywords:
troglitazone; blood pressure; vasodilation; insulin; stress, mental;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Sung, BH Millard Fillmore Hosp, Dept Med, CGF, 3 Gates Circle, Buffalo, NY14209 USA Millard Fillmore Hosp 3 Gates Circle Buffalo NY USA 14209 209 USA
Citazione:
B.H. Sung et al., "Vasodilatory effects of troglitazone improve blood pressure at rest and during mental stress in type 2 diabetes mellitus", HYPERTENSIO, 34(1), 1999, pp. 83-88

Abstract

The present study examined the hemodynamic mechanisms of blood pressure (BP) lowering by troglitazone in patients with type 2 diabetes mellitus (DM) at rest and during a mental arithmetic test (MAT). Twenty-two patients withDM with normal to high-normal BP and 12 controls matched for age,gender, glucose tolerance, and BP were studied. DM subjects showed significantly higher systolic BP response during MAT than controls (157 versus 139 mm Hg; P<0.01). All 22 DM patients and 5 of 12 controls had systolic BP>140 mm Hg during MAT. Heart rate and diastolic BP were not significantly different between the 2 groups. The DM group was then randomized to receive troglitazone (n=10; 400 mg/d) or glyburide (n=12; 20 mg/d). MAT was repeated after 6 months of treatment. Both treatments reduced glucose equally (-1.7 mmol/L for troglitazone and -1.5 mmol/L for glyburide), but only troglitazone reduced insulin (-15 mu U/mL; P<0.001) and C-peptide (-0.9 ng/mL; P<0.02) levels. Troglitazone significantly reduced BP at baseline (P<0.05) and systolic BP response to MAT (P<0.01), whereas glyburide did not affect BP at baseline orduring MAT. Stroke volume and cardiac output did not change with either drug, but troglitazone decreased peripheral vascular resistance (-112 dyne.s.cm(-5); P<0.05). Improved insulin resistance rather than an improved glycemic control is associated with lower resting and stress BP values in patients with DM. A reduction in vascular resistance may be a primary hemodynamic mechanism of the manner in which troglitazone lowers BP. Insulin sensitizers may offer potential therapeutic advantage in subjects with DM with elevated BP.

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Documento generato il 23/10/20 alle ore 09:55:57