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Metformin and blood pressure
1Department of Medicine II, University of Göteborg, Sahlgrenska Hospital, Sweden.
Insights
Metformin treatment in hypertensive patients improved insulin sensitivity and reduced blood pressure. This suggests insulin resistance may play a key role in primary hypertension and related metabolic issues.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- Hypertension is a significant risk factor for cardiovascular diseases like stroke and coronary artery disease.
- Insulin resistance and hyperinsulinemia are frequently observed in hypertensive individuals, regardless of obesity status.
- Primary hypertension may involve underlying metabolic and fibrinolytic abnormalities.
Purpose of the Study:
- To investigate the potential of metformin, an antidiabetic agent, in improving insulin sensitivity in non-obese, non-diabetic, untreated hypertensive patients.
- To explore the role of insulin resistance in the development and management of primary hypertension.
Main Methods:
- A pilot study administered metformin to non-obese, non-diabetic, untreated hypertensive individuals.
- Evaluated changes in insulin sensitivity, plasma insulin levels, lipid profiles, fibrinolytic activity, and blood pressure.
Main Results:
- Metformin significantly improved insulin sensitivity and decreased plasma insulin levels.
- Treatment with metformin led to reductions in serum cholesterol and triglycerides.
- A marked decrease in blood pressure and an increase in fibrinolytic activity were observed.
Conclusions:
- Insulin resistance may be a crucial factor in primary hypertension, often accompanied by metabolic and fibrinolytic abnormalities.
- The findings suggest that insulin resistance might precede the onset of hypertension in susceptible individuals.
- Metformin shows potential as a therapeutic agent for managing hypertension associated with insulin resistance.
Abstract:
Hypertension appears to predispose to both atheroma and thrombus formation and is a risk factor for stroke and coronary artery disease. Insulin resistance and hyperinsulinaemia are also associated with hypertension, whether treated or untreated and irrespective of obesity. In an attempt to treat the possible insulin resistance in hypertension, an antidiabetic agent, metformin, which enhances glucose uptake, was given to non-obese, non-diabetic, untreated hypertensives in a pilot study. Metformin improved insulin sensitivity, decreased plasma insulin, serum cholesterol and triglycerides, increased fibrinolytic activity and markedly decreased blood pressure. These findings support the concept that insulin resistance may be important in cases of primary hypertension, i.e. those with concomitant metabolic and possibly also fibrinolytic abnormalities. Furthermore, the results indicate that insulin resistance may precede hypertension in these cases.