title: Effect of doxazosin on fibrinolysis in hypertensive patients with and without insulin resistance.
abstract: The fibrinolytic and metabolic changes associated with doxazosin treatment were evaluated in 20 patients with mild to moderate hypertension. Steady-state plasma glucose (SSPG) concentration was used to subdivide hypertensive patients into two groups of 10 each: Insulin-resistant (SSPG > 190 mg/dl) and nonresistant (SSPG < 190 mg/dl). The blood pressure was normalized after 4 to 6 months of doxazosin treatment in both groups, but it was associated with significantly lower fasting plasma triglyceride level, lower integrated insulin response to a 75 gm oral glucose load, lower SSPG concentration, significant decreases in plasma plasminogen activator inhibitor type one antigen and activity and tissue plasminogen activator antigen, and a significant increase in tissue plasminogen activator activity only in the insulin-resistant group but not in the nonresistant group. It was also noted that the improvement of the fibrinolytic and metabolic abnormalities in the insulin-resistant group tended to return to the less abnormal levels seen in the non-resistant group. The data suggested that doxazosin treatment of hypertension attenuated much of the abnormalities of insulin resistance but had little effect on insulin-sensitive patients. It may support a link between impaired fibrinolysis and insulin resistance in patients with hypertension.
authors.affiliation: Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: J R
authors.initials: JR
authors.lastname: Jeng
authors.forename: W H
authors.initials: WH
authors.lastname: Sheu
authors.forename: C Y
authors.initials: CY
authors.lastname: Jeng
authors.forename: S H
authors.initials: SH
authors.lastname: Huang
authors.forename: S M
authors.initials: SM
authors.lastname: Shieh
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D017292:Doxazosin / Q000627:therapeutic use*; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000097:blood
chemical_list: D000317:Adrenergic alpha-Antagonists; D000959:Antihypertensive Agents; D001786:Blood Glucose; D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1; D010959:Tissue Plasminogen Activator; D017292:Doxazosin