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Insulin resistance may influence the selection of antihypertensive medicines in addition to the selection of drugs for hyperglycemia and dyslipidemia. ß blockers and thiazides can worsen insulin resistance, but ACE inhibitors and alpha-blockers can improve insulin resistance (Krentz, 1996). The HOPE researchers discovered that using an ACE inhibitor reduces the onset of new-onset diabetes (Yusuf, 2000). There is mounting evidence that ACE inhibitors and sartans have cardioprotective and renoprotective effects that are independent of blood pressure lowering. Many mechanisms have been proposed to explain these protective benefits, including effects on the endothelium and artery wall, some of which may be mediated by mechani

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