Objective: To investigate blood pressure-lowering effect of rosiglitazone in overweight/obese non-diabetic patients with hypertension to explore the therapeutic role of insulin sensitizers in the management of essential hypertension.
Methods: 89 cases of overweight/obese non-diabetics with essential hypertension were enrolled in a 4 weeks open label clinical trial. Rosiglitazone 8 mg/day were started 2 weeks after withdrawing previously used anti-hypertensive medications. Blood pressure was measured at the 2nd and 4th week. Plasma glucose and insulin levels during oral glucose tolerance test (OGTT) at baseline and at 4th week were also determined.
Results: After 4 weeks treatment with rosiglitazone, the mean systolic and diastolic blood pressure reduced by 17 mm Hg (1mm Hg = 0.133 kPa) and 11 mm Hg, respectively. Plasma insulin levels at fasting, 1 and 2 hour during OGTT decreased by 27%, 35% and 41%, respectively (P < 0.001), whereas insulin sensitivity increased by 30% (P < 0.001). The amplitude of reduction of blood pressure was related to the baseline level of blood pressure and insulin sensitivity, and family history of hypertension.
Conclusions: Rosiglitazone significantly reduces blood pressure in overweight and/or obese non-diabetic subjects with hypertension. Randomized controlled clinical trial is justified to confirm the therapeutic role of rosiglitazone in the management of non-diabetic essential hypertension.