EFFECT OF THE VASODILATORY BETA-BLOCKER, NIPRADILOL, AND CA-ANTAGONIST, BARNIDIPINE, ON INSULIN SENSITIVITY IN PATIENTS WITH ESSENTIAL-HYPERTENSION

Objectives To assess the effects of a vasodilatory beta -adrenoceptor blocker, nipradilol, and a long-acting Ca channel blocker, barnidipine , on insulin sensitivity. Design Insulin sensitivity was determined us ing a euglycemic hyperinsulinemic clamp technique before and after a 1 2-week treatment period in eighteen patients with essential hypertensi on. Results Both drugs decreased blood pressure without affecting any serum parameters of glucose and lipid metabolism. Nipradilol significa ntly augmented glucose infusion rate (GIR) from 3.11 +/- 0.28 to 4.69 +/- 0.57 mg/kg/min (p=0.027). Barnidipine also increased GIR from 3.91 +/- 0.43 to 5.29 +/- 0.43 mg/kg/min (p=0.028). Plasma norepinephrine concentrations significantly increased with barnidipine treatment, whi le nipradilol had no effect on plasma norepinephrine levels. No advers e events were reported during the study. Conclusions These results sug gest that vasodilatory beta -blockers such as nipradilol and long-acti ng Ca channel blockers such as barnidipine may be useful in the treatm ent of insulin resistant hypertensive patients.