A Haenni1, H Lithell. 1. Department of Public Health and Caring Sciences/Geriatrics, Uppsala, Sweden. arvo.hanni@geriatrik.uu.se
Abstract
OBJECTIVE: To study whether insulin sensitivity and insulin response are altered by moxonidine treatment in obese patients with mild essential hypertension. DESIGN: a prospective, double-blind, placebo-controlled, randomized, parallel group study. PATIENTS AND METHODS: 77 patients with mild essential hypertension and body mass index > 27 were enrolled. A placebo run-in period of 1-3 weeks was followed by 8-9 weeks of double-blind treatment with either placebo or moxonidine. Patients receiving antihypertensive drugs underwent a 4-week wash-out period preceeding the placebo run-in. Insulin sensitivity was evaluated by hyperinsulinaemic euglycaemic clamp test. Insulin response was measured during intravenous glucose tolerance test. RESULTS:72 patients completed the study. No serious adverse events were reported. The glucose infusion rate (M value), and insulin sensitivity index (M/I ratio) increased in the moxonidine-treated subjects by 10% (P = 0.025), and 11% (P = 0.04), respectively, whereas the values in the placebo group remained unchanged. In the predefined insulin-resistant subgroup with M/I ratio < 3.6 at baseline, glucose infusion rate and insulin sensitivity index increased by 21% whereas values in the placebo group remained unchanged. A between-group comparison showed a statistical significant difference in the M value (P = 0.026) and a borderline statistical difference in the M/I ratio (P = 0.056) in favour of moxonidine. No statistically significant effects were seen in the subgroup with a M/I ratio > or = or 3.6 at baseline. The insulin secretion in response to glucose stimulation was unaffected in insulin-resistant as well as in insulin-sensitive hypertensive patients. CONCLUSION:Moxonidine treatment improved insulin sensitivity in insulin-resistant, obese patients with mild hypertension, but not in insulin-sensitive obese subjects with mild hypertension, when compared to placebo. Insulin response to glucose stimulation was unaffected. The drug was well tolerated.
RCT Entities:
OBJECTIVE: To study whether insulin sensitivity and insulin response are altered by moxonidine treatment in obesepatients with mild essential hypertension. DESIGN: a prospective, double-blind, placebo-controlled, randomized, parallel group study. PATIENTS AND METHODS: 77 patients with mild essential hypertension and body mass index > 27 were enrolled. A placebo run-in period of 1-3 weeks was followed by 8-9 weeks of double-blind treatment with either placebo or moxonidine. Patients receiving antihypertensive drugs underwent a 4-week wash-out period preceeding the placebo run-in. Insulin sensitivity was evaluated by hyperinsulinaemic euglycaemic clamp test. Insulin response was measured during intravenous glucose tolerance test. RESULTS: 72 patients completed the study. No serious adverse events were reported. The glucose infusion rate (M value), and insulin sensitivity index (M/I ratio) increased in the moxonidine-treated subjects by 10% (P = 0.025), and 11% (P = 0.04), respectively, whereas the values in the placebo group remained unchanged. In the predefined insulin-resistant subgroup with M/I ratio < 3.6 at baseline, glucose infusion rate and insulin sensitivity index increased by 21% whereas values in the placebo group remained unchanged. A between-group comparison showed a statistical significant difference in the M value (P = 0.026) and a borderline statistical difference in the M/I ratio (P = 0.056) in favour of moxonidine. No statistically significant effects were seen in the subgroup with a M/I ratio > or = or 3.6 at baseline. The insulin secretion in response to glucose stimulation was unaffected in insulin-resistant as well as in insulin-sensitive hypertensivepatients. CONCLUSION:Moxonidine treatment improved insulin sensitivity in insulin-resistant, obesepatients with mild hypertension, but not in insulin-sensitive obese subjects with mild hypertension, when compared to placebo. Insulin response to glucose stimulation was unaffected. The drug was well tolerated.
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