Regression of Fatty Heart by Valsartan Therapy
Metabolic Syndrome, Lipotoxicity
About this trial
This is an interventional treatment trial for Metabolic Syndrome focused on measuring Metabolic syndrome, Lipotoxicity, Insulin sensitivity, Myocardial triglyceride levels, Hepatic triglyceride levels, Magnetic resonance spectroscopy
Eligibility Criteria
Inclusion Criteria:
Prediabetic individuals with impaired glucose tolerance (2 hr postprandial glucose > 140mg/dL) or having 3 of 5 Metabolic Syndrome criteria:
- Fasting glucose > 100mg/dL;
- Waist circumference: men > 102cm, women > 88cm (confirmed with abdominal MRI);
- HDL: men < 40mg/dL, women < 50mg/dL;
- Triglycerides > 150mg/dL;
- Blood pressure > 130/80mmHg;
- Elevated hepatic triglycerides (>5.5%) and myocardial triglycerides (>0.6%)
- Elevated blood triglycerides >150mg/dL
- Age < 50 years
Exclusion Criteria:
- Type 2 Diabetes mellitus
- Prior exposure to renin system blockers or HCTZ
- BP > 160/100mmHg
- Claustrophobia
- Metallic implants in body
- Pregnant or planning to become pregnant
- Prior exposure to statin medications
Sites / Locations
- University of Texas Southwestern Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Valsartan
Hydrochlorothiazide
This arm will determine if blockade of the renin-angiotensin system reduces myocardial fat levels and improves insulin sensitivity. It consists of 6 visits: visit1 (baseline); visit2 (2 weeks); visit3 (1 month); visit4 (3 month); visit5 (6 month); visit6 (8 month). Visits 1 & 6 will consist of blood tests, glucose tolerance test by FSivGTT, MRS, & 24 hr ambulatory blood pressure monitoring. During visit 1, patients receive automatic blood pressure monitor, OMRON, to record blood pressure between visits. Visits 2 & 3 are needed for the adjustment of medication to the final dose level. During visits 4 & 5, Dr. Price will check subject's status as they continue the medication. In case of uncontrolled blood pressure, Dr. Price will prescribe amlodipine for the additional BP control.
This arm will determine if thiazide diuretics elevate myocardial triglyceride levels. It consists of 6 visits: visit1 (baseline); visit2 (2 weeks); visit3 (1 month); visit4 (3 month); visit5 (6 month); visit6 (8 month). Visits 1 & 6 will consist of blood tests, glucose tolerance test by FSivGTT, MRS, & 24 hr ambulatory blood pressure monitoring. During visit 1, patients receive automatic blood pressure monitor, OMRON, to record blood pressure between visits. Visits 2 & 3 are needed for the adjustment of medication to the final dose level. During visits 4 & 5, Dr. Price will check subject's status as they continue the medication. In case of uncontrolled blood pressure, Dr. Price will prescribe amlodipine for the additional BP control.