An evaluation of ketanserin therapy for the hypertensive diabetic patient

Hypertension may accelerate the development of the vascular complications of diabetes but many conventional antihypertensive agents have adverse effects on glucose tolerance or peripheral perfusion. To investigate the potential of ketanserin as an antihypertensive agent for hypertensive diabetics we performed a randomly allocated, double-blind, placebo-controlled trial in 17 patients. A range of peripheral blood flow responses was determined using laser Doppler flowmetry, and diabetic control was assessed at the time of allocation to groups and after 8 weeks' therapy (20 mg twice a day for 2 weeks; 40 mg twice a day for 6 weeks). The mean decrease in standing blood pressure was 14.1/9.3 mmHg (ketanserin treatment) versus 7.1/5.9 mmHg (placebo). The maximum skin blood flow and a posturally induced vasoconstriction of the foot skin were unaffected by the therapy, and glycaemic control was unchanged. Ketanserin was well tolerated. These studies suggest that ketanserin may be a useful agent for the treatment of hypertension in the diabetic patient.