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| Item Type: | Article |
|---|---|
| Title: | Systemic and tissue-specific effects of aliskiren on the RAAS and carbohydrate/lipid metabolism in obese patients with hypertension |
| Creators Name: | Engeli, S. and May, M. and Nussberger, J. and Danser, A.H.J. and Dole, W.P. and Prescott, M.F. and Dahlke, M. and Stitah, S. and Pal, P. and Boschmann, M. and Jordan, J. |
| Abstract: | Aliskiren penetrates adipose and skeletal muscle in hypertensive patients with abdominal obesity and reduces renin-angiotensin-aldosterone system activity. After discontinuation, blood pressure-lowering effects are observed possibly through drug-tissue binding. We performed microdialysis evaluation of adipose tissue and skeletal muscle before and during an insulin-modified frequently sampled intravenous glucose tolerance test (IM-FSIGT). Aliskiren 300 mg (n = 8) or amlodipine 5 mg (n = 8) once daily were administered during a 12-week randomized treatment period. Aliskiren elicited variable changes in median interstitial angiotensin II (Ang II) in adipose (2.60-1.30 fmol/mL) and skeletal muscle (2.23-0.68 fmol/mL); amlodipine tended to increase adipose and skeletal muscle Ang II (P = .066 for skeletal muscle treatment difference). Glucose/insulin increased median plasma Ang II 1 hour after glucose injection (1.04-2.50 fmol/mL; P = .001), which was markedly attenuated by aliskiren but not amlodipine. Aliskiren increased glucose disposition index (P = .012) and tended to increase acute insulin response to glucose (P = .067). Fasting adipose glycerol (-17%; P = .064) and fasting muscle glucose dialysate (-17%; P = .025) were decreased by aliskiren but not amlodipine. In summary, aliskiren decreased Ang II production in response to glucose/insulin stimulus and elicited metabolic effects in adipose and skeletal muscle suggestive of increased whole-body glucose utilization. |
| Keywords: | Adipose Tissue, Amlodipine, Angiotensin II, Insulin Sensitivity, Microdialysis, Obesity, Plasma Renin Activity, Skeletal Muscle |
| Source: | Journal of the American Society of Hypertension |
| ISSN: | 1933-1711 |
| Publisher: | Elsevier |
| Volume: | 11 |
| Number: | 8 |
| Page Range: | 488-497 |
| Date: | August 2017 |
| Official Publication: | https://doi.org/10.1016/j.jash.2017.06.002 |
| PubMed: | View item in PubMed |
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