Clinical Usefulness of Doxazosin in Patients with Type 2 Diabetes Complicated by Hypertension: Effects on Glucose and Lipid Metabolism

Abstract

This uncontrolled study investigated the effects of using the α 1 -blocker doxazosin (2 mg or 4 mg daily for 3 months) to treat 21 hypertensive patients with type 2 diabetes, including eight obese individuals (body mass index [BMI] ≥ 25.0 kg/m 2 ). A significant reduction in systolic and diastolic blood pressure, beginning after 1 month of treatment, was seen. There was no significant change in BMI. Although there was no obvious improvement in glucose metabolism, doxazosin treatment noticeably reduced insulin resistance and significantly lowered triglyceride and free fatty acid levels. No significant changes were found in total cholesterol, highor low-density lipoprotein-cholesterol, atherosclerotic index, or small or large subfractions of low-density lipoproteincholesterol. None of the patients showed any adverse effects. The beneficial effects of doxazosin on blood pressure and lipid and glucose metabolism shown in this study suggest that this drug is clinically useful as an anti-hypertensive agent for patients with diabetes.

Computational Drug Repositioning Using Continuous Self-Controlled Case Series

“…Thiamine is reported to reduce the adverse effect of hyperglycemia by inhibiting certain biological pathways [40] and deficiency of thiamine is observed in diabetic patients [41]. Cardura is found to reduce insulin resilience in a study on hypertensive patients with diabetes [42]. According to [22], Prozac can cause both high or lower blood sugar while diltiazem is linked to low blood glucose level.…”

Doxazosin in the current treatment of hypertension

“…Some doxazosin metabolites, namely 6-and 7-hydroxydoxazosin, have radical scavenging properties and thus can prevent oxidation of LDL as well as of other substances [22,[59][60][61] . The drug has been reported to reduce or to have a neutral effect on plasma glucose level and improve insulin sensitivity [62][63][64][65][66][67][68] .…”

“…This agent in either form exerts favourable effects on serum lipid levels by decreasing total and low-density lipoprotein (LDL) cholesterol and increasing the high-density lipoprotein (HDL) cholesterol level [7,8,22,31,53,61,63,72,73] . Recently, it has been shown in experimental studies that doxazosin stimulates HDL biogenesis by increasing the expression of ATP-binding cassette transporter A1, which is responsible for the regulation of HDL synthesis [58] .…”

“…There are many 'beyond blood pressure' beneficial effects of doxazosin ( Table 2 ) [6][7][8][9]11,14,18,22,31,33,34,39,43,45,48,53,[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71] . This agent in either form exerts favourable effects on serum lipid levels by decreasing total and low-density lipoprotein (LDL) cholesterol and increasing the high-density lipoprotein (HDL) cholesterol level [7,8,22,31,53,61,63,72,73] .…”

Managing Hypertension in Patients with Diabetes

“…No data is available for tamsulosin. Doxazosin improved glucose and lipid metabolism in diabetic patients and in patients with impaired glucose tolerance [128,129]. It has also been reported to improve insulin resistance, and increase LDL particle size [130,131].…”