Trial reportJournal of hypertension2010
Angiotensin receptor blocker/diuretic combination preserves insulin responses in obese hypertensives.
Trial report in Journal of hypertension, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 36 citations in OpenAlex.
- Dietary sodium restriction decreases insulin secretion without affecting insulin sensitivity in humans.The Journal of clinical endocrinology and metabolism · 2014Trial
- Antihypertensive and metabolic effects of Angiotensin receptor blocker/diuretic combination therapy in obese, hypertensive African American and white patients.American journal of therapeutics · 2013Trial
- Efficacy and safety of triple antihypertensive therapy with the olmesartan/amlodipine/hydrochlorothiazide combination.Clinical drug investigation · 2012Trial
- Spironolactone prevents chlorthalidone-induced sympathetic activation and insulin resistance in hypertensive patients.Hypertension (Dallas, Tex. : 1979) · 2012Trial
- Effects of losartan on whole body, skeletal muscle and vascular insulin responses in obesity/insulin resistance without hypertension.Diabetes, obesity & metabolism · 2012Trial
- Office and ambulatory blood pressure-lowering effects of combination valsartan/hydrochlorothiazide vs. hydrochlorothiazide-based therapy in obese, hypertensive patients.Journal of clinical hypertension (Greenwich, Conn.) · 2011Trial
- Combination angiotensin-receptor blocker (ARB)/calcium channel blocker with HCTZ vs the maximal recommended dose of an ARB with HCTZ in patients with stage 2 hypertension: the exforge as compared to losartan treatment in stage 2 systolic hypertension (EXALT) study.Journal of clinical hypertension (Greenwich, Conn.) · 2011Trial
- Valsartan improves {beta}-cell function and insulin sensitivity in subjects with impaired glucose metabolism: a randomized controlled trial.Diabetes care · 2011Trial
- The Role of Renin-Angiotensin System in Diabetic Cardiomyopathy: A Narrative Review.Life (Basel, Switzerland) · 2023Review
- Article
- Article
- Perivascular adipose tissue as a regulator of vascular disease pathogenesis: identifying novel therapeutic targets.British journal of pharmacology · 2017Review
- Effects of aldosterone on insulin sensitivity and secretion.Steroids · 2014Review
- Impact of chronic diuretic treatment on glucose homeostasis.Diabetology & metabolic syndrome · 2013Article
- Diabetes mellitus and vascular disease.Hypertension (Dallas, Tex. : 1979) · 2013Article
- Metabolic impact of adding a thiazide diuretic to captopril.Hypertension (Dallas, Tex. : 1979) · 2013Article
- The renin angiotensin aldosterone system and insulin resistance in humans.Current hypertension reports · 2013Review
- Efficacy and tolerability of a single-pill combination of telmisartan 80 mg and hydrochlorothiazide 25 mg according to age, gender, race, hypertension severity, and previous antihypertensive use: planned analyses of a randomized trial.Integrated blood pressure control · 2013Article
- Does response of RAS blockade on serum K+ levels influence its glycemic-mitigating response when combined with hydrochlorothiazide?Journal of clinical hypertension (Greenwich, Conn.) · 2012Article
- Evidence-based hypertension treatment in patients with diabetes.Journal of clinical hypertension (Greenwich, Conn.) · 2012Review
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundThiazide diuretics can impair glucose metabolism and increase new-onset diabetes. Adding an angiotensin receptor blocker to diuretics may protect against these metabolic effects; however, the mechanism of this protection is unclear.
methodTo explore potential mechanisms, a 16-week multicenter trial was conducted to ascertain the relative glucose metabolism effects of combined hydrochlorothiazide and angiotensin receptor blocker (valsartan) therapy compared with hydrochlorothiazide and calcium channel blocker (amlodipine) treatment in 412 centrally obese hypertensive individuals (BMI = 35 +/- 7 kg/m, seated BP = 159 +/- 8/94 +/- 8 mmHg, and mean age 56 years). Individuals were randomized to valsartan/hydrochlorothiazide, with force-titration to 320/25 mg or hydrochlorothiazide, with titration to hydrochlorothiazide 25 mg and amlodipine 10 mg, respectively. Changes from baseline to week 16 in fasting and 2-h postprandial glucose and insulin levels after an oral glucose load were measured.
resultsAt week 16, clinic blood pressure reductions were similar (P > 0.05) in both groups. Fasting and 2-h glucose levels increased (P < 0.05) with the amlodipine combination but not with the valsartan combination. In concert with these glucose responses, postprandial insulin increases from baseline were substantially greater with valsartan than with amlodipine plus hydrochlorothiazide group (P = 0.001). The glucose responses were inversely related to insulin responses at the study conclusion.
conclusionThe novel observation of this investigation was that the combination of valsartan and hydrochlorothiazide was associated with greater glucose-stimulated insulin secretory and lesser glycemic excursion responses than the amlodipine combination group. Thus, this data suggests that adding an angiotensin receptor blocker attenuates the negative effects of thiazides on pancreatic beta-cell glucose-induced insulin secretion.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.