Selective alpha 1-adrenergic inhibition improves decrease glucose disposal in patients with essential hypertension

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Essential hypertension is associated with metabolic abnormalities, including altered insulin secretion and sensitivity.
• Hypertension may contribute to impaired glucose metabolism, increasing the risk of type 2 diabetes.

Purpose of the Study:

• To investigate the effects of doxazosin on insulin secretion and insulin sensitivity in patients with essential hypertension.
• To determine if short-term doxazosin treatment can improve glucose disposal rates in hypertensive individuals.

Main Methods:

• A study involving 11 nonobese patients with essential hypertension and 12 matched normotensive controls.
• Evaluation of insulin secretion and insulin sensitivity using plasma insulin, C-peptide levels, and euglycaemic clamp (M-value) before and after one month of doxazosin treatment.

Main Results:

• Hypertensive patients exhibited higher prestimulated and stimulated plasma insulin and C-peptide levels compared to normotensive controls.
• The insulin-mediated glucose disposal rate (M-value) was significantly lower in the hypertensive group (7.32 +/- 0.56 mg/kg/min) versus controls (8.88 +/- 0.34 mg/kg/min).
• Doxazosin treatment reduced blood pressure and significantly improved the M-value to 8.60 +/- 0.62 mg/kg/min without altering C-peptide levels.

Conclusions:

• Essential hypertension is characterized by increased insulin secretion and impaired insulin sensitivity.
• Selective alpha 1-adrenergic inhibition with doxazosin can improve insulin sensitivity and glucose disposal rates in hypertensive patients.
• Doxazosin may offer a therapeutic benefit beyond blood pressure reduction by improving metabolic parameters in hypertension.