Losartan Versus Hydrochlorothiazide in Reversing Remodeling of Small Arteries in Pre-Hypertensive Pre-Diabetic Subjects

Inclusion Criteria: * Prehypertensive prediabetic subjects (25-70 years old) defined as otherwise normal subjects with a mean SiSBP of 120-139 mmHg and fasting blood glucose of 6.1-6.9 mmol/L or impaired glucose tolerance on oral glucose tolerance test (OGTT) at screening and after two weeks of placebo therapy (Week -2) Exclusion Criteria: * Hypertension or clinically significant renal disease * Cerebrovascular accident within the past year, or current transient ischemic attacks * Myocardial infarction within the past year; percutaneous coronary angioplasty or coronary artery bypass surgery within last 6 months * Clinically significant AV conduction disturbances and/or arrhythmias (e.g. second- or third-degree AV block; sick-sinus syndrome or clinically significant bradycardia- resting heart rate \< 45 beats/minute), tachyarrhythmias; clinically significant arrhythmias, presence of accessory bypass tract (e.g. Wolff-Parkinson-White syndrome) * Angina pectoris * Current or prior history of heart failure or known left ventricular ejection fraction \<40% * History of unexplained syncope or known syncopal disorder (e.g., Stokes-Adams Syndrome) * Known history of hemodynamically significant obstructive valvular disease or hypertrophic cardiomyopathy * Use of agents that may cause alteration of blood pressure is prohibited. This includes nitrates, or alpha or beta-blockers. Calcium channel blockers are allowed as second line therapy if hypertension develops during the study Majo…