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Metabolic effects of isradipine as monotherapy or in combination with pindolol during long‐term antihypertensive treatment
Author(s) -
LIND L.,
BERNE C.,
POLLARE T.,
LITHELL H.
Publication year - 1994
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1994.tb01117.x
Subject(s) - pindolol , isradipine , medicine , blood pressure , endocrinology , placebo , propranolol , dihydropyridine , calcium , alternative medicine , pathology
. Design . Open long‐term study with parallel groups. Setting . Kungsgärdet Geriatric Hospital, Uppsala, a tertiary referral hospital. Subjects . Twenty‐six untreated hypertensive subjects. Interventions . After 4 weeks on placebo, isradipine was titrated up to 10 mg daily to achieve appropriate blood pressure control ( n = 11). If this failed, 5–10 mg pindolol was added. The treatments were continued for 2 years. Main outcome measures . Blood pressure, lipoprotein measurements, intravenous glucose tolerance test, hyperinsulinaemic euglycaemic clamp, HbA ***1c , body weight. Conclusions . The hypotensive effect of isradipine was sustained during long‐term use but was associated with weight gain and an impaired glucose control. When isradipine was combined with pindolol there was also a reduction in insulin sensitivity and an increase in VLDL triglycerides, possibly as effects of the beta‐adrenergic blockade. Objectives . To evaluate the effects of isradipine alone and in combination with pindolol on glucose and lipid metabolism during long‐term antihypertensive therapy. Results . Treatment with isradipine alone caused a sustained reduction in blood pressure (‐22/‐10 mm Hg, P < 0.01), but an increase in body weight (+ 2.2 kg, P < 0.05) and HbA ***1c (+ 1.5%; P < 0.001) were also noted. Addition of pindolol resulted in a similar degree of blood pressure reduction and weight gain, whilst HbA ***1c was less affected (+ 1.0%; P < 0.05, compared to isradipine alone). Insulin sensitivity became impaired in both groups (– 1.2 to – 1.5 mg kg ‐1 min ‐1 ; P < 0.01 for M ‐value at hyperinsulinaemic clamp) but after adjustment for the change in body weight the impairment was only significant ( P < 0.01) in the group with combined treatment. The combined treatment also resulted in an increase in very‐low‐density‐lipoprotein (VLDL) triglyderides (+ 0.37 mmol L ‐1 ; P < 0.05).