Angiotensin II receptor blockade and insulin sensitivity in overweight and obese adults with elevated blood pressure

Ther Adv Cardiovasc Dis. 2013 Feb;7(1):11-20. doi: 10.1177/1753944712471740. Epub 2013 Jan 17.

Abstract

We tested the hypothesis that olmesartan, an angiotensin II receptor blocker (ARB) devoid of peroxisome proliferator-activated receptor γ agonist activity, would improve whole-body insulin sensitivity in overweight and obese individuals with elevated blood pressure (BP). Sixteen individuals (8 women, 8 men; age=49.5 ± 2.9 years; body mass index=33.0 ± 1.7 kg/m2) were randomly assigned in a crossover manner to control and ARB interventions. Insulin sensitivity was determined from intravenous glucose tolerances tests before and after each 8-week intervention. BP, body weight, body fat, lipid and lipoprotein concentrations, and insulin sensitivity were similar at baseline for both treatments (all p > 0.05). Diastolic BP and triglyceride concentrations were higher (p = 0.007 and 0.042 respectively) at baseline for the ARB compared with the control intervention. Systolic (-11.7 mmHg; p = 0.008) and diastolic (-12.1 mmHg; p = 0.0001) BP decreased, however insulin sensitivity did not change (p > 0.05) following ARB treatment. Furthermore, there were no significant correlates of changes in insulin sensitivity following the ARB intervention. In summary, our findings indicate that short-term ARB treatment did not affect whole-body insulin sensitivity in overweight or obese individuals with elevated BP. Future studies are needed to clarify the effect of individual ARBs on insulin sensitivity in obesity.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Angiotensin Receptor Antagonists / therapeutic use*
  • Biopsy
  • Cross-Over Studies
  • Female
  • Glucose Tolerance Test
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / metabolism
  • Imidazoles / therapeutic use*
  • Insulin Resistance / physiology*
  • Male
  • Middle Aged
  • Muscle, Skeletal / metabolism
  • Obesity / complications
  • Obesity / metabolism*
  • Overweight / complications
  • Overweight / metabolism*
  • Renin-Angiotensin System / drug effects
  • Renin-Angiotensin System / physiology
  • Tetrazoles / therapeutic use*
  • Treatment Outcome

Substances

  • Angiotensin Receptor Antagonists
  • Imidazoles
  • Tetrazoles
  • olmesartan