TY - JOUR
T1 - Rosiglitazone improves, while glibenclamide worsens blood pressure control in treated hypertensive diabetic and dyslipidemic subjects via modulation of insulin resistance and sympathetic activity
AU - Yosefy, Chaim
AU - Magen, Eliahu
AU - Kiselevich, Ada
AU - Priluk, Rita
AU - London, Daniel
AU - Volchek, Lior
AU - Viskoper, Reuven J.
PY - 2004/8/1
Y1 - 2004/8/1
N2 - Background: Type II diabetes is often associated with high blood pressure, elevated sympathetic activity, and high plasma insulin levels. Hypoglycemic agents may negatively interfere with blood pressure control, sympathetic activity, and plasma insulin level; therefore the choice of treatment in type II diabetes may be crucial. We aimed to compare the effects of two hypoglycemic drugs on blood glucose, blood pressure, sympathetic activity, and insulin levels in type II diabetic and hypertensive patients. Methods: Forty-eight (24M, 24F) type II diabetic, hypertensive, and hyperlipidemic subjects were enrolled and treated for 4 weeks with an ACE inhibitor (Cilazapril) and a statin (Simvastatin). They were then randomized into two groups to receive a thiazolidinedione (Rosiglitazone; ROS) or a sulfonylurea (Glibenclamide; GLB) for 8 weeks. Blood biochemistry, blood pressure, plasma insulin, endothelial function, and sympathetic skin activity were measured before and after treatment. Results: A significant drop in systolic and diastolic blood pressure by 6.1 ± 4.1 mm Hg and 4.2 ± 1.9 mm Hg respectively; a reduction in plasma insulin concentration by 4.3 ± 1.9mU/L and a decline in skin sympathetic activity were observed in the group receiving ROS. The GLB group showed an increase in systolic blood pressure by 3.1 ± 2.5 mm Hg, no change in diastolic blood pressure, significant elevation in plasma insulin concentration by 2.3 ± 1.4 mu/L, and augmentation of sympathetic activity. No significant changes in endothelial function were observed in either group. Conclusions: Rosiglitazone improved both plasma glucose and blood pressure levels, probably by attenuation of hyperinsulinemia and sympathetic activity, while Glibenclamide worsened blood pressure control possibly by elevation of insulin levels and activation of the sympathetic system.
AB - Background: Type II diabetes is often associated with high blood pressure, elevated sympathetic activity, and high plasma insulin levels. Hypoglycemic agents may negatively interfere with blood pressure control, sympathetic activity, and plasma insulin level; therefore the choice of treatment in type II diabetes may be crucial. We aimed to compare the effects of two hypoglycemic drugs on blood glucose, blood pressure, sympathetic activity, and insulin levels in type II diabetic and hypertensive patients. Methods: Forty-eight (24M, 24F) type II diabetic, hypertensive, and hyperlipidemic subjects were enrolled and treated for 4 weeks with an ACE inhibitor (Cilazapril) and a statin (Simvastatin). They were then randomized into two groups to receive a thiazolidinedione (Rosiglitazone; ROS) or a sulfonylurea (Glibenclamide; GLB) for 8 weeks. Blood biochemistry, blood pressure, plasma insulin, endothelial function, and sympathetic skin activity were measured before and after treatment. Results: A significant drop in systolic and diastolic blood pressure by 6.1 ± 4.1 mm Hg and 4.2 ± 1.9 mm Hg respectively; a reduction in plasma insulin concentration by 4.3 ± 1.9mU/L and a decline in skin sympathetic activity were observed in the group receiving ROS. The GLB group showed an increase in systolic blood pressure by 3.1 ± 2.5 mm Hg, no change in diastolic blood pressure, significant elevation in plasma insulin concentration by 2.3 ± 1.4 mu/L, and augmentation of sympathetic activity. No significant changes in endothelial function were observed in either group. Conclusions: Rosiglitazone improved both plasma glucose and blood pressure levels, probably by attenuation of hyperinsulinemia and sympathetic activity, while Glibenclamide worsened blood pressure control possibly by elevation of insulin levels and activation of the sympathetic system.
KW - Diabetes
KW - Glibenclamide
KW - Hypertension
KW - Rosiglitazone
KW - Sympathetic activity
UR - http://www.scopus.com/inward/record.url?scp=3242783305&partnerID=8YFLogxK
U2 - 10.1097/00005344-200408000-00011
DO - 10.1097/00005344-200408000-00011
M3 - Article
C2 - 15243303
AN - SCOPUS:3242783305
SN - 0160-2446
VL - 44
SP - 215
EP - 222
JO - Journal of Cardiovascular Pharmacology
JF - Journal of Cardiovascular Pharmacology
IS - 2
ER -