Influence of the nonsulfhydryl angiotensin-converting enzyme inhibitor trandolapril on lipid and carbohydrate metabolism related to exercise capacity in healthy subjects

Abstract

Epidemiologic studies have demonstrated that essential hypertension is frequently coassociated with a reduced glucose tolerance, hyperinsulinemia, and dyslipidemia, a combination that dramatically increases the risk of coronary artery disease. 1–3 To provide for the significant increase in the fuel and oxygen requirements of the working skeletal muscle, the performance of dynamic exercise is accompanied by major, potentially beneficial, metabolic adjustments. In this context enhancement of insulin sensitivity and lipolysis and an increase in cellular glucose and free fatty acid (FFA) utilization are of importance, resulting in marked reductions in plasma insulin, glucose, and triglyceride levels in the presence of elevated plasma high-density lipoprotein (HDL) cholesterol concentrations. 4–6 Based on these observations, dynamic physical exercise has been recognized as a useful treatment, alone and in combination with drug medication, for essential hypertension and other cardiovascular risk factors. 7 With respect to pharmacotherapy of essential hypertension, it is evident that the full benefit is only achievable if (1) no negative effects on glucose and lipid metabolism related to rest and physical exercise are induced, and (2) physical performance is not impaired in quality and quantity. The present studies were performed to determine the effects of the angiotensin-converting enzyme (ACE) inhibitor trandolapril 9 on maximum work capacity and also the received perception of exertion (RPE) estimated by the Borg scale on lipid and carbohydrate metabolism during aerobic physical exercise.