Indian Write- Ups

1  2

Documented the levels of Free Fatty Acid (FFA) and fructosamine in untreated and treated Hypertensive patients who had MI and NIDDM differed significantly (0.001) from those of control group. Fructosamine provides short-term glycaemic alterations in type II diabetes11. It is obvious from the result obtained that enalapril influence the fructosamine and FFA simultaneously in treated patients may be the consequences of improved insulin sensitivity. Insulin induced activation and translocation of glucose transport involves both activation and translocation of glucose transporters GLUT 1 and GLIT 412. There is some evidence that inhibition of Angiotensin converting enzyme activity can improve the uptake and conversion of glucose by heart and skeletal muscle in diabetics13. Though the effect of enalapril and atenolol on blood pressure are similar14-15, there metabolic effects are different and divergent. Atenolol worsens fructosamine in treated patients. This indicates that atenolol weakens the insulin sensitivity, decline glucose transporter GLUT 4, impair glucose uptake in diabetic heart13. The common factor for such consequences in Hypertensive patients with MI and Diabetes mellitus is insulin. Allison et al reported that Myocardial infarction results in suppression of insulin secretion and increasing the secretion of catacholamines16. As a result blood glucose level are elevated, glucose entry into myocardial cells are reduced and levels of FFA are further elevated. Therefore the metabolic imbalance that is seen after MI in diabetic patients can be effectively controlled but there is no evidence of such improvement. Insulin does not involve directly in myocardial damage but the metabolic changes are the reflection of its role in pathogenesis of hypertension.

Blood pressure is believed to be a common factor that linked hypertension to other metabolic disorder in human disease. Therefore the present study was undertaken to evaluate fructosamine and FFA in HT with MI in NIDDM before and after treatment with antihypertensive drugs found to possess different and divergent metabolic effect. It is obvious from the results obtained that fructosamine correlates with FFA. Enalapril attenuated fructosamine with simultaneous reduction in FFA whereas atenolol influences adversely on Fructosamine and FFA in Hypertension with MI in NIDDM patients.

1  2