Effects of Pioglitazone in Nondiabetic Patients with Arterial Hypertension: A Double-Blind, Placebo-Controlled Study

• Published in: The journal of clinical endocrinology and metabolism 2002-12, Vol.87 (12), p.5503-5506
• Main Authors: Füllert, S., Schneider, F., Haak, E., Rau, H., Badenhoop, K., Lübben, G., Usadel, K.-H., Konrad, T.
• Format: Article
• Language: English
• Subjects: Apolipoproteins B - blood; Blood Glucose - analysis; Cholesterol, HDL - blood; Double-Blind Method; Fasting - blood; Female; Homeostasis; Humans; Hypertension - drug therapy; Hypoglycemic Agents - therapeutic use; Insulin - blood; Insulin - physiology; Male; Middle Aged; Placebos; Thiazoles - therapeutic use; Thiazolidinediones
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2002-020963

Hypertension is often associated with insulin resistance, dyslipidemia and obesity, which indicate a prediabetic state and increased risk of cardiovascular disease. Pioglitazone treatment of patients with type 2 diabetes reduces insulin resistance and improves lipid profiles. The present double-blind placebo-controlled study is the first study to report effects of pioglitazone in non-diabetic patients with arterial hypertension. Following a one week run-in, 60 patients were randomized to receive either pioglitazone (45 mg/day) or placebo for 16 weeks. Insulin sensitivity (M-value) increased by 1.2 ± 1.7 mg/min/kg with pioglitazone compared with 0.4 ± 1.4 mg/min/kg (P = 0.022) with placebo. HOMA index was decreased (−22.5 ± 45.8) by pioglitazone but not by placebo (+0.8 ± 26.5; P < 0.001). Decreases in fasting insulin and glucose were significantly (P = 0.002 and P = 0.004, respectively) greater with pioglitazone than placebo. Body weight did not change significantly with either treatment. HDL-cholesterol was increased and apolipoprotein B was decreased to a significantly greater extent with pioglitazone. There was a significantly (P = 0.016) greater decrease from baseline in diastolic blood pressure with pioglitazone. These changes would suggest improved glucose metabolism and a possible reduction in risk of cardiovascular disease with pioglitazone treatment of non-diabetic patients with arterial hypertension.