Inclusion Criteria:

• age 18-70 years
• type 2 diabetes mellitus
• with or without hypertension
• healthy volunteers

Exclusion Criteria:

• ischemic changes on resting electrocardiogram,
• clinical evidence of heart disease (angina, heart failure, unstable angina),cerebrovascular or peripheral vascular disease,
• significant cardiac arrhythmias,
• aortic stenosis,
• 2nd or 3rd degree atrio-ventricular block, sinus node disease, or symptomatic bradycardia,
• bronchospastic lung disease with active wheezing,
• known hypersensitivity to adenosine,
• hemoglobin A1C > 8.5%, *
• gout (If not already taking HCTZ)
• the use of Rosiglitazone
• eGFR < 60 ml/min,
• serum potassium > 5.0 mmol/L,
• use of potassium-sparing diuretics,
• current smoker,*
• pregnancy,
• renal disease not related to diabetes mellitus,
• uncontrolled hypertension, systolic BP >160 mm Hg and diastolic BP >100 mm Hg *,
• use of hormone replacement therapy
• past intolerance of ACE inhibitor therapy

• other major medical illnesses. Subjects with evidence of ischemia on the first adenosine-stimulated PET study will be withdrawn from the study.

  • * Subjects can enroll in study and proceed with in-patient evaluations if during the run-in period adjustments of medications, diet and habits lead to improved glucose control (equivalent to HbA1c <8.5%), controlled hypertension and cessation of smoking.