Rosiglitazone reduces office and diastolic ambulatory blood pressure following 1‐year treatment in non‐diabetic subjects with insulin resistance

Abstract

Objective. Rosiglitazone (RSG) has been reported to reduce blood pressure (BP) in patients with type‐2 diabetes, but similar effects in non‐diabetic people with insulin resistance is less clear. Our aim was to test the long‐term BP‐lowering effects of RSG compared with placebo. Methods. We recruited participants for BP evaluation of RSG treatment from a larger intervention trial. Office BP was recorded in 355 non‐diabetic subjects with insulin resistance randomized to receive either RSG or placebo for 52 weeks. Ambulatory BP monitoring (ABPM; Spacelab 90207) was performed in a subgroup of 24 subjects (RSG: n = 11; placebo n = 13). Results. After 1 year, the office BP decreased by −3.1 mmHg systolic (p<0.05) and −3.8 mmHg diastolic (p<0.001) in the RSG group versus placebo. In patients treated with RSG, at 1 year there was a trend for a reduction from baseline for mean 24‐h diastolic BP (DBP), daytime DBP and night‐time DBP (−4.39, −5.26 and −2.93 mmHg, respectively). However, only daytime DBP was significantly lower in the RSG group compared with control (adjusted mean difference: −4.41 mmHg, p = 0.007). There was also a non‐significant trend for a reduction in mean 24‐h systolic BP (SBP), daytime SBP and night‐time SBP (−2.70, −2.51 and −3.35 mmHg, respectively). Conclusions. RSG treatment for 1 year was associated with a small but significant decrease in diastolic 24‐h ambulatory diastolic BP, and both systolic and diastolic office BPs in non‐diabetic people with insulin resistance.