Short-term metabolic effects of isradipine and metoprolol in pre-eclampsia

Objective To study the effects of isradipine or metoprolol on insulin sensi tivity and lipid profiles as well as on blood pressure and umbilical vascul ar resistance in preeclamptic women in the third trimester of pregnancy. Design A single-centre, prospective, randomized, double-blind, double-dummy and parallel-group study. Setting Helsinki University Central Hospital, a tertiary referral centre. Patients Twenty-four previously healthy pregnant women with normal findings in an oral glucose-tolerance test who were hospitalized for preeclampsia, of whom 17 completed the study. Interventions Between 29 and 39 weeks of gestation, measurements were made of insulin sensitivity (the minimal model), magnitude of proteinuria, and t he fasting levels of serum uric acid, lipids and lipoproteins. Subsequently , treatment with isradipine 2.5 mg (n = 9) or metoprolol 50 mg (n = 8) twic e daily was started, and these women were reinvestigated 5-7 days later. Bl ood pressure was recorded during 24 h by automated ambulatory blood pressur e measurement. Umbilical artery resistance index was measured by Doppler ul trasound. Main outcome measures Insulin sensitivity, uric acid, degree of proteinuria , lipids and lipoproteins, blood pressure, umbilical artery resistance inde x. Results Isradipine or metoprolol did not affect insulin sensitivity, degree of proteinuria, blood pressure, or the umbilical artery resistance index. Serum uric acid increased in both groups (P < 0.05). High-density lipoprote in(2) cholesterol increased 15.6% in the isradipine group (P < 0.05), but n o significant changes appeared in other lipids and lipoproteins in either g roup. Conclusions In this study, short-term antihypertensive treatment with israd ipine or metoprolol in preeclampsia had no detrimental effect on serum lipi d and lipoprotein levels or insulin sensitivity, J Hypertens 1999, 17:1189- 1194 (C) Lippincott Williams & Wilkins.