The data do not suggest that any one ACE inhibitor is better or worse at lowering BP .
ACE inhibitor doses above Max did not significantly lower BP more than Max .
There are no clinical ly meaningful BP lowering differences between different ACE inhibitors .
BACKGROUND ACE inhibitors are widely prescribed for hypertension so it is essential to determine and compare their effects on blood pressure ( BP ) , heart rate and withdrawals due to adverse effects ( WDAE ) .
OBJECTIVES To quantify the dose-related systolic and /or diastolic BP lowering efficacy of ACE inhibitors versus placebo in the treatment of primary hypertension .
Trandolapril does not improve insulin sensitivity in patients with hypertension and type 2 diabetes: a double-blind, placebo-controlled crossover trial.
Angiotensin-converting enzyme ( ACE ) inhibitors are increasingly used as first-line therapy for hypertension in type 2 diabetes mellitus and are widely believed to improve insulin sensitivity ( M ) . However , the evidence for the latter effect does not st and close scrutiny . We have assessed the effect of the ACE inhibitor tr and olapril on M in 16 patients ( mean + /- SD age , 58 + /- 10.6 yr ) with mild-to-moderate essential hypertension ( initial blood pressure , 173 + /- 14.5/93 + /- 8.0 mm Hg ) , obesity ( body mass index , 30 + /- 5.4 kg/m2 ) , and impaired glucose intolerance ( n = 4 ) or type 2 diabetes ( n = 12 ) in a double-blind , placebo-controlled crossover design . All patients underwent three 3-h euglycemic hyperinsulinemic clamp studies ( soluble insulin , 1.5 mU/kg x min ) after a 2-week placebo run-in and at the end of two 4-week periods of treatment with 2 mg tr and olapril or placebo ( 2-week washout ) . M ( mean + /- SD ) did not change with tr and olapril : placebo ( run-in ) , 5.2 + /- 1.98 mg/kg x min ; placebo , 5.3 + /- 1.70 mg/kg x min ; tr and olapril , 5.1 + /- 1.65 mg/kg x min ; P = 0.58 ; 95 % confidence intervals , -0.74 , 0.43 ( tr and olapril vs. placebo ) ; 95 % power to exclude an 8 % increase in M. In conclusion , tr and olapril had no clinical ly relevant effect on M in patients with hypertension and type 2 diabetes . Previous reports of improved M during ACE inhibitor treatment may be attributable to suboptimal study design and /or use of surrogate measures of
The data do not suggest that any one ACE inhibitor is better or worse at lowering BP .
ACE inhibitor doses above Max did not significantly lower BP more than Max .
There are no clinical ly meaningful BP lowering differences between different ACE inhibitors .
BACKGROUND ACE inhibitors are widely prescribed for hypertension so it is essential to determine and compare their effects on blood pressure ( BP ) , heart rate and withdrawals due to adverse effects ( WDAE ) .
OBJECTIVES To quantify the dose-related systolic and /or diastolic BP lowering efficacy of ACE inhibitors versus placebo in the treatment of primary hypertension .