Effect of Chronic ACE and DPP4 Inhibition on Blood Pressure

Inclusion Criteria: Age 18 to 80 years old For female subjects the following conditions must be met: Postmenopausal status for at least 1 year, or Status-post surgical sterilization, or If of childbearing potential, utilization of barrier methods of birth control and willingness to undergo urine β-HCG testing prior to drug treatment and on every study day T2DM, as defined by 1 or more of the following at the time of screening visit: * Hgb A1C ≥6.5%, or * Fasting plasma glucose ≥126mg/dL, or * 2-hour plasma glucose ≥200 mg/dL following 75gr oral glucose load Hypertension, as defined by: * Seated SBP ≥130 mm Hg on three occasions documented in medical record, or * Seated DBP ≥80 mm Hg on three occasions documented in medical record, or * Treatment with antihypertensive medications for a minimum of 6 months Exclusion Criteria: * Type 1 diabetes * Poorly controlled T2DM, defined as Hgb A1C\>8.7% * Use of anti-diabetic medications other than metformin for at least 12 months prior to initiation of the study * Secondary hypertension * Subjects who have participated in a weight-reduction program during the last 6 months and whose weight has increased or decreased more than 5 kg over the preceding 6 months * Pregnancy * Breast-feeding * Treatment with drugs primarily metabolized through CYP3A4 (e.g. cisapride, pimozide) * Clinically significant gastrointestinal impairment that could interfere with drug absorption * Cardiovascular disease such as myocardial infarction within 6 months prior to enrollment, presence of angina pectoris, significant arrhythmia, congestive heart failure (LV hypertrophy and diastolic dysfunction acceptable), deep vein thrombosis, pulmonary embolism, second- or third-degree AV block, mitral valve stenosis, or hypertrophic cardiomyopathy * Impaired hepatic function (aspartate amino transaminase \[AST\] and/or alanine amino transaminase \[ALT\] \>3 x upper limit of normal range) * Impaired renal function (eGFR\< 50mL/min/1.73m2 as determined by the MDRD equation) * History or presence of immunological or hematological disorders. * History of pancreatitis or know pancreatic lesion * History of angioedema while taking an ACE inhibitor * Hematocrit \<35% * Treatment with anticoagulants * Diagnosis of asthma requiring use of inhaled β-2 agonist more than 1 time per week * Any underlying or acute disease requiring regular medication which could possibly pose a threat to the subject or make implementation of the protocol or interpretation of the study results difficult * Treatment with systemic glucocorticoids within the last 6 months * Treatment with lithium salts * Treatment with any investigational drug in the 1 month preceding the study * Mental conditions rendering the subject unable to understand the nature, scope, or possible consequences of the study * Inability to comply with the protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study