Comparison of the effects of atenolol and nifedipine on glucose, insulin, and lipid metabolism in patients with hypertension.

Various aspects of carbohydrate and lipid metabolism have been studied in two groups of patients with mild hypertension before and after four months of treatment with either nifedipine (n = 12) or atenolol (n = 12). Mean (+/- SEM) blood pressure fell to the same degree following treatment with either nifedipine (147 +/- 3/98 +/- 2 to 134 +/- 2/85 +/- 2 mm Hg) or atenolol (149 +/- 3/99 +/- 2 to 135 +/- 2/86 +/- 3 mm Hg). Circulating plasma glucose, insulin, and triglyceride concentrations were measured at hourly intervals from 8:00 AM to 4:00 PM, before and after breakfast (8:00 AM), and at lunch time (noon). The response to treatment was different in the two groups. Specifically, plasma glucose concentration were unchanged and insulin concentrations were higher in association with atenolol treatment. In contrast, nifedipine-treated patients had similar plasma insulin, but lower plasma glucose and triglyceride concentrations after four months of therapy. The changes in day-long plasma glucose and insulin responses suggested that resistance to insulin-stimulated glucose uptake had increased in association with atenolol treatment and decreased following nifedipine. This conclusion was supported in that measurement of insulin-stimulated glucose disposal showed a decrease in atenolol-treated patients and an increase in nifedipine-treated patients. Finally, plasma lipoprotein cholesterol concentrations did not change following atenolol therapy, whereas plasma high density lipoprotein cholesterol increased in association with nifedipine administration. These data show that changes in carbohydrate and lipid metabolism observed with treatment of mild hypertension can vary significantly as a function of the drug used, despite similar beneficial effects on blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

RCT Entities:   Population Interventions Outcomes