[Efficacy of and tolerance to prolonged release prazosin in patients with hypertension and non-insulin dependent diabetes].
The treatment of hypertension represents one of the major elements of the cardiovascular prognosis in type II diabetes. Among antihypertensive drugs, alpha blockers may be interesting because of the absence of unfavourable effects on plasma glucose and lipid levels.


OBJECTIVE
The aim of this study was to evaluate the effectiveness and the safety of prazosin osmotic tablet treatment in non-insulin-dependent diabetic patients with mild to moderate arterial hypertension.


METHODS
After an initial 4-week-single-blind placebo period, 81 hypertensive subjects (162 +/- 11/96 +/- 5 mmHg) with type II diabetes were included in the study to receive prazosin osmotic tablet (o.t) open-label therapy at the dose of 2.5 mg/day for 12 weeks. After 4 weeks of treatment the dosage of prazosin o.t was increased to 5 mg/day if the diastolic blood pressure remained > or = 90 mmHg.


RESULTS
Both supine and standing systolic and diastolic blood pressures were significantly decreased (P < 0.001) with prazosin therapy from 162 +/- 10/96 +/- 5 mmHg in supine and 160 +/- 12/95 +/- 6 mmHg in the upright position, to 149 +/- 15/86 +/- 9 mmHg and 148 +/- 16/86 +/- 9 mmHg respectively at the end of the 12-week-treatment period. There were no significant changes in the glycemic parameters (glycemia, haemoglobin A1c) during the prazosin therapy compared with baseline values. A significant decrease of triglycerides (P = 0.005), total cholesterol (P < 0.001) and LDL cholesterol (P = 0.03) levels was observed during prazosin therapy compared with the baseline measurements, whereas HDL cholesterol remained stable. Only 6% of the patients reported adverse events in relation with the study drug during the active treatment period.


CONCLUSIONS
This study showed a significant decrease of the blood pressure in hypertensive subjects with type II diabetes after prazosin o.t treatment, without any change of glycemic parameters. Moreover, there was a favourable evolution of the lipidic parameters during the study characterised by a significant decrease of triglycerides and total and LDL cholesterol.
Hanon
O
O
Service de médecine interne, hôpital Broussais, 96, rue Didot, 75014 Paris, France. olivier.hanon@wanadoo.fr
Giacomino
A
A
Troy
S
S
Bernaud
C
C
Girerd
X
X
Weber
S
S
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016037:Single-Blind Method
D000959:Antihypertensive Agents; D003692:Delayed-Action Preparations; D011224:Prazosin