CATCH IR--CANDESARTAN IN AFRICAN AMERICANS W/ HYPERTENSION & INSULIN RESISTANCE

非裔美国人的靶器官终末疾病强调有必要进一步研究这一疾病过程的潜在病理生理机制，以更有效地确定治疗方法。我们假设血管紧张素II受体阻滞剂坎地沙坦Cilexitil将减少高血压患者的血管肥厚，从而改善胰岛素抵抗的主要部位骨骼肌的血管供应(研究A)。骨骼肌血管供应的变化将促进骨骼肌纤维类型结构的进一步变化。结果将是，从基线到治疗结束，快抽动与慢抽动纤维的比率增加，骨骼肌水平和全身新陈代谢的胰岛素敏感性全面改善(研究B)。

Target end organ disease among African Americans emphasizes the need for further investigation into the underlying pathophysiologic mechanisms of this desease process to more effectively determine treatment. We hypothesize that Candesartan Cilexitil, an angiotensin II receptor blocker will reduce vascular hypertrophy in hypertensives and therefore improve vascular supply to skeletal muscle, the primary site for insulin resistance (Study A). The change in vascular supply to the skeletal muscle will promote a further change in the architecture of the skeletal muscle fiber type. The result will be an increase in the fast twitch to slow twitch fiber ratio from baseline to the end of treatment and an overall improvement in insulin sensitivity at the skeletal muscle level and whole body metabolism ( Study B).