Effect of cilnidipine on insulin sensitivity in patients with essential hypertension.
To clarify the effect of cilnidipine, a long-acting dihydropyridine Ca-antagonist that blocks both L- and N-type Ca(2+)-channels, on insulin sensitivity, cilnidipine at 5 to 10 mg/day was administered to ten patients with essential hypertension for 12 weeks. Mean age and body mass index (BMI) were 57.7 +/- 5.0 (SEM) years old and 27.1 +/- 1.5, respectively. Blood pressure, serum levels of catecholamines, glucose and lipid were determined before and after the treatment. Insulin sensitivity was also measured by a euglycemic hyperinsulinemic clamp method using an artificial pancreas (STG-22; Nikiso, Tokyo, Japan) before and after the treatment. Cilnidipine administration significantly lowered blood pressure from 154/96 to 137/84 mmHg (p<0.05). The glucose infusion rate was significantly increased by 20.8%, from 3.27 +/- 0.36 to 3.95 +/- 0.55 mg/kg/min (p<0.05). HbA1C and serum lipid levels such as total cholesterol and triglyceride were not altered. In addition, cilnidipine treatment did not significantly increase serum norepinephrine levels (278 +/- 25.2 vs. 332 +/- 33.6 pg/ml). Our results suggest that cilnidipine improves insulin sensitivity, possibly due to its exerting a vasodilatory action without stimulating sympathetic nervous activity.
Yagi
Shinji
S
Fourth Department of Medicine, Saitama Medical School, Saitama, Japan.
Goto
Seiichi
S
Yamamoto
Taro
T
Kurihara
Susumu
S
Katayama
Shigehiro
S
D001786:Blood Glucose; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D020746:Calcium Channels, L-Type / Q000502:physiology; D002395:Catecholamines / Q000097:blood; D004095:Dihydropyridines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D013564:Sympathetic Nervous System / Q000187:drug effects
D001786:Blood Glucose; D002121:Calcium Channel Blockers; D020746:Calcium Channels, L-Type; D002395:Catecholamines; D004095:Dihydropyridines; D007328:Insulin; D008055:Lipids; C065927:cilnidipine