Short-term metabolic effects of isradipine and metoprolol in pre-eclampsia.
OBJECTIVE
To study the effects of isradipine or metoprolol on insulin sensitivity and lipid profiles as well as on blood pressure and umbilical vascular resistance in pre-eclamptic women in the third trimester of pregnancy.


METHODS
A single-centre, prospective, randomized, double-blind, double-dummy and parallel-group study.


METHODS
Helsinki University Central Hospital, a tertiary referral centre.


METHODS
Twenty-four previously healthy pregnant women with normal findings in an oral glucose-tolerance test who were hospitalized for preeclampsia, of whom 17 completed the study.


METHODS
Between 29 and 39 weeks of gestation, measurements were made of insulin sensitivity (the minimal model), magnitude of proteinuria, and the fasting levels of serum uric acid, lipids and lipoproteins. Subsequently, treatment with isradipine 2.5 mg (n = 9) or metoprolol 50 mg (n = 8) twice daily was started, and these women were reinvestigated 5-7 days later. Blood pressure was recorded during 24 h by automated ambulatory blood pressure measurement. Umbilical artery resistance index was measured by Doppler ultrasound.


METHODS
Insulin sensitivity, uric acid, degree of proteinuria, lipids and lipoproteins, blood pressure, umbilical artery resistance index. sensitivity, degree of proteinuria, blood pressure, or the umbilical artery resistance index. Serum uric acid increased in both groups (P<0.05). High-density lipoprotein2 cholesterol increased 15.6% in the isradipine group (P<0.05), but no significant changes appeared in other lipids and lipoproteins in either group.


CONCLUSIONS
In this study, short-term antihypertensive treatment with isradipine or metoprolol in preeclampsia had no detrimental effect on serum lipid and lipoprotein levels or insulin sensitivity.
Laivuori
H M
HM
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland. hannele.laivuori@pp.fimnet.fi
Laakso
M
M
Tikkanen
M J
MJ
Cacciatore
B
B
Ylikorkala
R O
RO
Kaaja
R J
RJ
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000502:physiology; D017275:Isradipine / Q000494:pharmacology / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use*; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies; D014469:Umbilical Arteries / Q000187:drug effects / Q000502:physiology
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D007328:Insulin; D008055:Lipids; D008074:Lipoproteins; D008790:Metoprolol; D005947:Glucose; D017275:Isradipine