CHANGES IN GLUCOSE, INSULIN, LIPID, LIPOPROTEIN, AND APOPROTEIN CONCENTRATIONS AND INSULIN ACTION IN DOXAZOSIN-TREATED PATIENTS WITH HYPERTENSION - COMPARISON BETWEEN NONDIABETIC INDIVIDUALS AND PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Thirty patients with hypertension were enrolled in this study, 13 had non-insulin-dependent diabetes mellitus (NIDDM) and 17 were nondiabeti c. Patients were treated with doxazosin for approximately 4 months, an d blood pressure fell significantly (P < .001) in both nondiabetics (1 49/96 to 134/85 mm Hg) and in those with NIDDM (154/96 to 143/84 mm Hg ). In the nondiabetic group, doxazosin treatment was associated with s ignificant improvement in insulin-mediated glucose disposal (P < .05) and lower plasma insulin (P < .001), and triglyceride (P < .001) conce ntrations measured at hourly intervals from 8 AM to 4 PM (breakfast at 8 AM and lunch at noon). In addition, fasting total plasma (P < .001) and VLDL cholesterol (P < .01), and total plasma (P < .05), VLDL (P < .08), LDL (P < .01), HDL (P < .01) triglyceride concentrations were l ower following doxazosin treatments in the nondiabetic group, as was t he ratio of total to HDL cholesterol (P < .001). Finally, apoprotein B concentrations fell with doxazosin in the nondiabetic group (P < .01) . Significant changes seen in the group with NIDDM included a decrease in the ratio of total to HDL cholesterol (P <.001) and a fall in apop rotein B concentration (P < .05). However, values for all other variab les did not change significantly with treatment in this group. Thus, d oxazosin treatment of nondiabetic subjects with high blood pressure wa s associated with a series of changes in glucose, insulin, and lipopro tein metabolism that should decrease risk of coronary heart disease (C HD) in these individuals. In the case of patients with both high blood pressure and NIDDM, except for a decrease in total/HDL cholesterol ra tio and apoprotein B concentration, the effect of doxazosin treatment on CHD risk in patients appeared to be neutral.