METABOLIC EFFECTS OF COMBINED ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH TYPE 2 DIABETES

Abstract

Aim. To evaluate antihypertensive effect of a 12-week therapy with fixed combination of enalapril and indapamide on insulin resistance (IR), glucose, lipid and purine metabolism in patients with arterial hypertension (HT) and diabetes mellitus (DM) type 2.Material and methods. 30 patients with HT stage II-III and DM type 2 aged 40-65 years were included into the study. Antihypertensive therapy with fixed-dose combination of enalapril (10 mg) and indapamide(2.5 mg) was initiated for 12 weeks. The level of office systolic blood pressure (SBP) and diastolic blood pressure (DBP), the concentration of glucose, glycosylated hemoglobin, basal insulin, uric acid, fasting lipid profile in the venous blood and IR were assessed.Results. Target blood pressure values were achieved in all patients. After 12 weeks of treatment, there were significant changes in office SBP (Δ%=-23.6) and DBP (Δ%=-12.9) as compared with the baseline values. Metabolic index, characterizing the degree of insulin resistance, decreased significantly by 22.5% (17.8±1.4 baseline vs 13.8±1.4 after 12 weeks of treatment) and atherogenic index decreased by 18.4% (3.16±0.2 baseline vs 2.58±0.17 after 12 weeks of treatment, p&lt;0.05). There was no deterioration of glucose and purine metabolism during the follow-up.Conclusion. Combined antihypertensive therapy with enalapril and indapamide for 12 weeks significantly lowers SBP and DBP, the degree of IR, does not affect carbohydrate, lipid and purine metabolism in patients with HT and DM type 2, i.e. it’s metabolically neutral.</p