Effect of doxazosin on insulin resistance in hypertensive patients with obesity.
We determined the effect of alpha-adrenergic blocking agent doxazosin on insulin resistance in 19 hypertensive patients (blood pressure [BP] >160/90 mmHg) with obesity (mean body mass index [BMI]: 26.7 +/- 1.9 kg/m (2)). Patients received doxazosin 4 mg/day for 12 months. Systolic and diastolic BP decreased from 169 +/- 10.8 mmHg to 147 +/- 11.9 mmHg (p < 0.0001) and from 102 +/- 8.1 mmHg to 87 +/- 5.0 mmHg (p < 0.0001), respectively. Insulin resistance and fasting immunoreactive insulin (IRI) were lower at study end vs. baseline (HOMA-R = 1.29 +/- 0.38 vs. 3.58 +/- 2.23 [p = 0.022]; IRI = 6.00 +/- 1.88 microU/ml vs 13.74 +/- 8.51 microU/ml [p = 0.046]). Total cholesterol was significantly reduced following treatment. Circulating TNF-alpha and leptin levels decreased significantly within 3 months of treatment; leptin was independently associated with insulin resistance when adjusted for BMI. We conclude that doxazosin improves insulin resistance and improves dyslipidemia in obese hypertensive patients, and has a beneficial effect on adipose endocrine activity.
D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism; D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology*; D000328:Adult; D000704:Analysis of Variance; D017292:Doxazosin / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications* / Q000188:drug therapy*; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000378:metabolism
D000317:Adrenergic alpha-Antagonists; D017292:Doxazosin