Metabolic effects of ramipril treatment in hypertensive subjects with non-insulin-dependent diabetes mellitus
Janka, H.U.; Nuber, A.; Mehnert, H.
Arzneimittel-Forschung 40(4): 432-435
1990
ISSN/ISBN: 0004-4172 PMID: 2141472 Document Number: 359000
The antihypertensive and metabolic effects of the new long-acting angiotensin converting enzyme (ACE) inhibitor, ramipril (Hoe 498), were assessed in 21 patients with non-insulin-dependent diabetes mellitus (NIDDM) over a 12-week treatment period. In an average dose of 5 mg given once daily, ramipril effectively reduced the elevated blood pressure. In 74% of the cases systolic and diastolic blood pressure was normalised during monotherapy. Mean blood glucose and glycosylated hemoglobin (HbAI) values showed a slight but significant (p less than 0.05) decrease at the end of the ramipril treatment period (glucose: 8.5 +/- 1.4 mmol/l vs 8.0 +/- 0.9 mmol/l; HbAI: 10.0 +/- 1.3% vs 9.7 +/- 1.1%). C-peptide levels did not change. Since there was also a small reduction of body weight during treatment, the observed hypoglycemic response could not be fully ascribed to ramipril. Also, a reduction in total cholesterol and an increase of HDL cholesterol could be documented during treatment with ramipril. The reduction in body weight could also be made partly responsible for this positive effect on lipid metabolism. No serious side effects were reported during the entire study period. Due to these beneficial effects, ramipril can be recommended as first-line drug in the management of hypertensive subjects with NIDDM.