Effects of pioglitazone in nondiabetic patients with arterial hypertension: a double-blind, placebo-controlled study

J Clin Endocrinol Metab. 2002 Dec;87(12):5503-6. doi: 10.1210/jc.2002-020963.

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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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
  • Pioglitazone
  • Placebos
  • Thiazoles / therapeutic use*
  • Thiazolidinediones*

Substances

  • Apolipoproteins B
  • Blood Glucose
  • Cholesterol, HDL
  • Hypoglycemic Agents
  • Insulin
  • Placebos
  • Thiazoles
  • Thiazolidinediones
  • Pioglitazone