Combination therapy with angiotensin-converting enzyme inhibitors and indapamide impairs glucose tolerance in Chinese hypertensive patients

Abstract

Background. Elevated blood glucose (BG) induced by antihypertensive agents increases the risk of cardiovascular events. This study was designed to investigate whether fosinopril+indapamide combination therapy has any effect on glucose tolerance (GT), and if it did, whether conversion to fosinopril alone could reverse the impaired GT. Methods. Included in the present study were 124 hypertensive patients, of whom 62 patients were treated with fosinopril plus indapamide (F/I group) and the remaining 62 patients were treated with fosinopril alone (F group). Of them, 89 patients completed a mean of 14-month follow-up. In the F/I group, 29 patients were converted to the use of fosinopril for 4–12 months after they completed the follow-up. Results. In the F group, fasting BG decreased significantly from 5.1±0.5 to 4.8±0.7 mmol/l (p<0.01), and 2-h postprandial BG decreased significantly from 7.2±1.6 to 6.4±1.4 mmol/l (p<0.01), while in the F/I group, fasting BG increased significantly from 5.1 ±0.6 to 5.3±0.9 mmol/l (p<0.05), and 2-h postprandial BG increased significantly from 7.2±1.7 to 7.7±1.8 mmol/l (p<0.05). In 29 patients of the F/I group who completed the follow-up and were converted to fosinopril, fasting BG decreased significantly from 5.5±1.0 to 5.3±1.0 mmol/l (p<0.05), and 2-h postprandial BG decreased significantly from 7.5±2.0 to 7.0±2.7 mmol/l (p<0.05). Conclusion. Fosinopril+indapamide combination therapy impaired GT in Chinese hypertensive patients, and fosinopril alone was able to reverse fosinopril+indapamide-induced GT impairment in part of these patients.