ANTIHYPERTENSIVE AND METABOLIC EFFECTS OF DOXAZOSIN IN HYPERTENSIVE PATIENTS WITH CONCOMITANT NON-INSULIN-DEPENDENT DIABETES-MELLITUS

In this multicentre, non-randomized clinical study, 35 hypertensive pa tients with concomitant non-insulin-dependent diabetes mellitus were t reated with the selective alpha(1) adrenoceptor blocker doxazosin mesi late for 24 weeks, either alone or together with existing antihyperten sive therapy. The effects of the drug on blood pressure, glucose and l ipid metabolism were examined. Daily administration of 0.5 - 8 mg doxa zosin caused a significant reduction in both systolic and diastolic bl ood pressure within 2 weeks. This effect was stable and lasted the ent ire trial period. The mean systolic and diastolic blood pressure decre ased from 172 +/- 15/90 +/- 11 mmHg at the beginning, to 149 +/- 19/80 +/- 12 mmHg at the end of the trial. Heart rate was not affected. The plasma glucose level showed no change, whereas the haemoglobin A(1C) level decreased significantly from 7.4 +/- 1.2% to 7.1 +/- 1.2% (P < 0 .01). Total and high-density lipoprotein cholesterol levels remained u nchanged. The triglycerides level, however, decreased from 113 +/- 54 mg/dl at the beginning to 98 +/- 49 mg/dl at the end of the trial (P < 0.05). In a subgroup of patients, who showed hypercholesterolaemia (g reater than or equal to 220 mg/dl, n = 9) at the beginning, the total cholesterol level decreased from 252 +/- 33 mg/dl to 220 +/- 33 mg/dl (P < 0.05). Two patients complained of abdominal fullness or diarrhoea , but both were easily manageable. The results indicate that doxazosin is effective and safe in the treatment of hypertension in noninsulin- dependent diabetics and does not affect glucose metabolism, As for lip id metabolism in non-insulin-dependent diabetic patients, doxazosin se ems to have a beneficial effect.