A trial of the calcium antagonist nisoldipine in hypertensive non-insulin-dependent diabetic patients.
The antihypertensive and metabolic effects of a new calcium antagonist nisoldipine (10 to 20 mg at night) were investigated in 14 mild to moderately hypertensive non-insulin-dependent diabetic patients (median age 62, range 50-70 years). In a 12-week placebo controlled single blind study, sitting and standing blood pressure were significantly lowered (p less than 0.001). Heart rate was unchanged as were blood urea, creatinine, bilirubin, mmol/l (mean +/- SEM) and uric acid concentrations. Plasma sodium levels fell during active therapy (142 +/- 0.5 mmol/l (mean +/- SEM) versus 139 +/- 0.5 (p less than 0.001) and remained lower during the washout period. Plasma calcium concentrations increased during nisoldipine therapy (2.41 +/- 0.02 versus 2.51 +/- 0.03 mmol/l, p less than 0.001) and returned towards baseline during the washout period. Plasma ionized calcium concentrations showed similar changes but plasma sodium and calcium remained within the normal laboratory ranges in all patients at all times. Serum triglyceride concentrations fell (placebo 1.9 +/- 0.02 mmol/l vs nisoldipine 1.6 +/- 0.2, p less than 0.05), but fasting cholesterol was unchanged. Fasting blood glucose, and the blood glucose response to oral glucose challenge (75 g) showed no differences though HbA1 concentrations fell (10.6 +/- 0.7 versus 9.2 +/- 0.05%, p less than 0.05) and tended to rise when the drug was withdrawn. Haemoglobin concentrations also fell during active therapy (14.7 +/- 0.4 vs 14 +/- 0.32 g/dl p less than 0.001) and also remained lower after the washout period (13.9 +/- 0.03 g/dl).(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015737:Nisoldipine; D012964:Sodium / Q000097:blood
D001786:Blood Glucose; D002121:Calcium Channel Blockers; D008055:Lipids; D015737:Nisoldipine; D012964:Sodium; D009543:Nifedipine