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 .
Insulin sensitivity in hypertensive Type 2 diabetic patients after 1 and 19 days' treatment with trandolapril.
AIMS The aims of this study were to examine the effects of tr and olapril , a long acting angiotensin converting enzyme ( ACE ) inhibitor with high tissue uptake , on insulin sensitivity and lipid concentrations in hypertensive patients with Type 2 diabetes mellitus . METHODS Insulin sensitivity was assessed after an acute dose ( day 3 ) and 19 days continuous treatment ( days 3 - 21 ) using the isoglycaemic , hyperinsulinaemic glucose clamp with D[3 - 3H ] labelled glucose , a variable D[3 - 3H ] priming dose and a ' hot ' glucose infusion .  Rates of glucose appearance ( Ra ) and glucose disappearance ( Rd ) were isotopically determined during the basal and insulin stimulated periods of the clamp . Twenty-four ( 5 female ) hypertensive ( blood pressure > 75th centile for age and sex ) patients with Type 2 diabetes mellitus were studied . Patients were r and omized , in a double-blind manner , to either tr and olapril 4 mg daily ( T ) or placebo ( P ) . RESULTS Baseline ( day 1 ) systolic ( mean + /- SD ; P 164+/-14 and T 168+/-13 mm Hg ) and diastolic ( P 93+/-6 , and T 98+/-10 mm Hg ) blood pressures were comparable . On days 3 and 21 , significant reductions were observed in both groups ( P<0.001 ) . In the tr and olapril-treated group , serum tr and olapril concentrations were > 200 pg/ml on days 3 and 21 , in all patients apart from one subject at a single visit , while tr and olapril was undetectable in the placebo group . Body mass index ( BMI ) was greater in T compared with P ( 32.2+/-5.4 v. 28.3+/-4.6 , P = 0.07 ) . After correcting for BMI , basal hepatic glucose output ( HGO ) P 2.6 ( 95 % CI 2.23 - 3.13 ) and T 1.91 ( 1.33 - 2.51 ) mg x kg(-1 ) x min(-1 ) and clamped HGO P 0.32 ( -0.44 - 1.09 ) and T 0.87 ( 0.40 - 1.34 ) mg x kg(-1 ) x min(-1 ) were similar in both groups . The insulin sensitivity index was comparable in both groups on all days . Total cholesterol concentrations were similar in both groups throughout the study . Triglyceride concentrations were significantly lower in group P 1.38 ( 1.07 - 1.68 ) ; T 2.14 ( 1.70 - 2.58 ) mmol/l , P<0.01 ) , no significant treatment effect being observed . CONCLUSIONS An acute dose and 19 days ' continuous treatment with tr and olapril result ed in no change in insulin sensitivity or plasma lipid profiles in patients with Type 2 diabetes mellitus and hypertension . These data support the metabolic neutrality of tr and olapril in patients with Type 2 diabetes mellitus and hypertension
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 .