[The effect of amlodipine, nifedipine and perindopril on insulin sensitivity and blood lipid of patients with essential hypertension].
OBJECTIVE
To investigate the effect of amlodipine, nifedipine and perindopril on insulin sensitivity(IS) and blood lipid of patients with essential hypertension(EH).


METHODS
105 EH patients were randomly divided into 3 groups: amlodipine group; nifedipine group; perindopril group. Treatment period lasted for 4 weeks. Before and after treatment, IS was measured by euglycemic insulin clamp technique with glucose metabolism rate (M) as an index of IS.


RESULTS
Amlodipine, nifedipine and perindopril significantly reduced blood pressure compared with that before treatment(P < 0.01). In the EH patients with decreased IS, the M value (mg.kg-1.min-1) after the use of amlodipine, nifedipine and perindopril was higer than that before treatment (amlodipine: 6.6 +/- 1.5 Vs 4.6 +/- 0.6, P < 0.01; nifedipine: 5.2 +/- 1.2 Vs 4.4 +/- 0.6, P < 0.05; perindopril: 6.8 +/- 1.6 Vs 4.4 +/- 0.6, P < 0.01). The increase of M value(mg.kg-1.min-1), nifedipine (1.2 +/- 0.9) were significantly lower than that of amlodipine(2.1 +/- 1.1) and perindopril(2.4 +/- 1.5), P < 0.01, respectively, but no significant difference was found between amlodipine and perindopril(P > 0.05).


CONCLUSIONS
Amlodipine and perindopril have beneficial effect on improving insulin sensitivity in EH patients with decreased insulin sensitivity. The effect of nifedipine on insulin sensitivity is lower than that of amlodipine and perindopril. Blood lipid is not significantly changed after short treatment.
Department of Cardiology, Fujian Institute of Hypertension, First Affiliated Hospital, Fujian Medical University, Fuzhou.
J
J
Lin
D
D
Chen
K
K
Wu
D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D020913:Perindopril / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D008055:Lipids; D017311:Amlodipine; D009543:Nifedipine; D020913:Perindopril