HEMODYNAMIC AND METABOLIC EFFECTS OF TRANSDERMAL CLONIDINE IN PATIENTS WITH HYPERTENSION AND NON-INSULIN-DEPENDENT DIABETES-MELLITUS

The aim of this study was to evaluate the effect of transdermal clonid ine on hemodynamic and metabolic parameters in patients who have eleva ted blood pressure and non-insulin-dependent diabetes mellitus (NIDDM) . After a 2-week run in placebo period, 20 NIDDM patients who had dias tolic blood pressure in the range of 90 to 105 mm Hg underwent a rando mized, single blind, placebo controlled, cross-over study of 4 week tr eatment with clonidine (transdermal patch 2.5 mg/week) or placebo (ina ctive patch). Compared with placebo, clonidine significantly reduced s ystolic (153 +/- 6 v 163 +/- 8) and diastolic (88 +/- 2 v 98 +/- 3.5 m m Hg, P = .001) blood pressure, left ventricular mass (94 +/- 11 v 99 +/- 12 g/m(2), P < .01) and fasting glucose levels. Total glucose disp osal (glucose clamp) was 6.5 +/- 1.5 with placebo and 7.1 +/- 1.6 mg/k g/min with clonidine (P < .01). Oxidative glucose disposal (indirect c alorimetry) was also greater after clonidine. Plasma glucose, insulin, and C-peptide responses following oral glucose (75 g) were significan tly lower after clonidine, as well as urinary albumin excretion. Trans dermal clonidine is effective in reducing blood pressure in hypertensi ve NIDDM patients and is well tolerated. It may be useful to reduce th e cardiovascular impact of hypertension in diabetes mellitus. (C) 1998 American Journal of Hypertension, Ltd.