This Article Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints, Permissions and Rights Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Füllert, S. Articles by Konrad, T. Search for Related Content PubMed PubMed Citation Articles by Füllert, S. Articles by Konrad, T.

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

Medical Department I, J. W. Goethe University (S.F., F.S., E.H., H.R., K.B., K.-H.U.), Frankfurt, Germany; Institute for Metabolic Research (T.K.), Frankfurt, Germany; and Takeda Pharma (G.L.), Aachen, Germany

Address correspondence to: Thomas Konrad, M.D., Institut für Stoffwechselforschung, European RISC Study Centre, Heidelbergerstrasse 13, D-60327 Frankfurt, Germany.

Abstract

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.

This article has been cited by other articles:

				C. D. Sigmund Endothelial and Vascular Muscle PPAR{gamma} in Arterial Pressure Regulation: Lessons From Genetic Interference and Deficiency Hypertension, February 1, 2010; 55(2): 437 - 444. [Full Text] [PDF]

				H. Nakaya, B. D. Summers, A. C. Nicholson, A. M. Gotto Jr., D. P. Hajjar, and J. Han Atherosclerosis in LDLR-Knockout Mice Is Inhibited, but Not Reversed, by the PPAR{gamma} Ligand Pioglitazone Am. J. Pathol., June 1, 2009; 174(6): 2007 - 2014. [Abstract] [Full Text] [PDF]

				E. Erdmann, J. A. Dormandy, B. Charbonnel, M. Massi-Benedetti, I. K. Moules, A. M. Skene, and on behalf of the PROactive Investigators The Effect of Pioglitazone on Recurrent Myocardial Infarction in 2,445 Patients With Type 2 Diabetes and Previous Myocardial Infarction: Results From the PROactive (PROactive 05) Study J. Am. Coll. Cardiol., May 1, 2007; 49(17): 1772 - 1780. [Abstract] [Full Text] [PDF]

				I. Bogacka, T. W. Gettys, L. de Jonge, T. Nguyen, J. M. Smith, H. Xie, F. Greenway, and S. R. Smith The Effect of {beta}-Adrenergic and Peroxisome Proliferator-Activated Receptor-{gamma} Stimulation on Target Genes Related to Lipid Metabolism in Human Subcutaneous Adipose Tissue Diabetes Care, May 1, 2007; 30(5): 1179 - 1186. [Abstract] [Full Text] [PDF]

				R. A Ajjan and P. J Grant Cardiovascular disease prevention in patients with type 2 diabetes: the role of oral anti-diabetic agents Diabetes and Vascular Disease Research, December 1, 2006; 3(3): 147 - 158. [Abstract] [PDF]

				A. Zanchi, C. Perregaux, M. Maillard, D. Cefai, J. Nussberger, and M. Burnier The PPAR{gamma} agonist pioglitazone modifies the vascular sodium-angiotensin II relationship in insulin-resistant rats Am J Physiol Endocrinol Metab, December 1, 2006; 291(6): E1228 - E1234. [Abstract] [Full Text] [PDF]

				A. Basu, M. D. Jensen, F. McCann, D. Mukhopadhyay, M. J. Joyner, and R. A. Rizza Effects of pioglitazone versus glipizide on body fat distribution, body water content, and hemodynamics in type 2 diabetes. Diabetes Care, March 1, 2006; 29(3): 510 - 514. [Abstract] [Full Text] [PDF]

				A. J.M. Rennings, P. Smits, M. W. Stewart, and C. J. Tack Fluid retention and vascular effects of rosiglitazone in obese, insulin-resistant, nondiabetic subjects. Diabetes Care, March 1, 2006; 29(3): 581 - 587. [Abstract] [Full Text] [PDF]

				P. O. Szapary, L. T. Bloedon, F. F. Samaha, D. Duffy, M. L. Wolfe, D. Soffer, M. P. Reilly, J. Chittams, and D. J. Rader Effects of Pioglitazone on Lipoproteins, Inflammatory Markers, and Adipokines in Nondiabetic Patients with Metabolic Syndrome Arterioscler Thromb Vasc Biol, January 1, 2006; 26(1): 182 - 188. [Abstract] [Full Text] [PDF]

				N. Rasouli, A. Yao-Borengasser, L. M. Miles, S. C. Elbein, and P. A. Kern Increased plasma adiponectin in response to pioglitazone does not result from increased gene expression Am J Physiol Endocrinol Metab, January 1, 2006; 290(1): E42 - E46. [Abstract] [Full Text] [PDF]

				M.R. Langenfeld, T. Forst, C. Hohberg, P. Kann, G. Lubben, T. Konrad, S.D. Fullert, C. Sachara, and A. Pfutzner Pioglitazone Decreases Carotid Intima-Media Thickness Independently of Glycemic Control in Patients With Type 2 Diabetes Mellitus: Results From a Controlled Randomized Study Circulation, May 17, 2005; 111(19): 2525 - 2531. [Abstract] [Full Text] [PDF]

				C. Patel, K. L Wyne, and D. K McGuire Thiazolidinediones, peripheral oedema and congestive heart failure: what is the evidence? Diabetes and Vascular Disease Research, May 1, 2005; 2(2): 61 - 66. [Abstract] [PDF]

				B. Cariou, J.-C. Fruchart, and B. Staels Review: Vascular protective effects of peroxisome proliferator-activated receptor agonists The British Journal of Diabetes & Vascular Disease, May 1, 2005; 5(3): 126 - 132. [Abstract] [PDF]

				B. Kimmel and S. E. Inzucchi Oral Agents for Type 2 Diabetes: An Update Clin. Diabetes, April 1, 2005; 23(2): 64 - 76. [Abstract] [Full Text] [PDF]

				D. Walcher and N. Marx Insulin resistance and cardiovascular disease: the role of PPAR{gamma} activators beyond their anti-diabetic action Diabetes and Vascular Disease Research, October 1, 2004; 1(2): 76 - 81. [Abstract] [PDF]

				A. Zanchi, A. Chiolero, M. Maillard, J. Nussberger, H.-R. Brunner, and M. Burnier Effects of the Peroxisomal Proliferator-Activated Receptor-{gamma} Agonist Pioglitazone on Renal and Hormonal Responses to Salt in Healthy Men J. Clin. Endocrinol. Metab., March 1, 2004; 89(3): 1140 - 1145. [Abstract] [Full Text] [PDF]

				A. D. Dobrian, S. D. Schriver, A. A. Khraibi, and R. L. Prewitt Pioglitazone Prevents Hypertension and Reduces Oxidative Stress in Diet-Induced Obesity Hypertension, January 1, 2004; 43(1): 48 - 56. [Abstract] [Full Text] [PDF]

				R. N. Bergman Insulin Action and Distribution of Tissue Blood Flow J. Clin. Endocrinol. Metab., October 1, 2003; 88(10): 4556 - 4558. [Full Text] [PDF]

				K. Winkler, T. Konrad, S. Fullert, I. Friedrich, R. Destani, M. W. Baumstark, K. Krebs, H. Wieland, and W. Marz Pioglitazone Reduces Atherogenic Dense LDL Particles in Nondiabetic Patients With Arterial Hypertension: A double-blind, placebo-controlled study Diabetes Care, September 1, 2003; 26(9): 2588 - 2594. [Abstract] [Full Text] [PDF]