Doxazosin in metabolically complicated hypertension.
Metabolic syndrome, a cluster of metabolic abnormalities with visceral obesity and insulin resistance as its central component, is highly prevalent among hypertensive patients. Hypertension complicated by metabolic syndrome is associated with an increased risk of cardiovascular disease and new-onset Type II diabetes mellitus that further aggravates the prognostic outlook. Such a complex condition requires a multifactorial intervention including blood pressure lowering, improvement of the adverse metabolic profile and delayed onset of new diabetes. In this respect, doxazosin and other alpha-1 adrenoceptor blocking agents are of interest given their effect on the lipid profile in dyslipidemic, obese hypertensive patients, either diabetic or not. Doxazosin improves insulin sensitivity, apparently by accelerating insulin and glucose disposal through vasodilatation of skeletal muscle vascular beds. Whether long-term treatment with the drug might delay, or possibly prevent, incident Type II diabetes in hypertension complicated by metabolic syndrome is an intriguing possibility to be tested in appropriately designed clinical trials.
Dell'Omo
Giulia
G
Università di Pisa, Dipartimento Cardio Toracico e Vascolare, 56100 Pisa, Italy. gdellomo@med.unipi.it
Penno
Giuseppe
G
Del Prato
Stefano
S
Pedrinelli
Roberto
R
D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D004039:Diet, Sodium-Restricted; D004305:Dose-Response Relationship, Drug; D017292:Doxazosin / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000317:Adrenergic alpha-Antagonists; D017292:Doxazosin