Hypertension and Diabetes

Zanella, Maria Teresa; Santiago, Regina C. M.; Sá, João Roberto de; Salgado, Bernardete Jorge; Faria, Sandra F. G. de Lopes; Peres, Ricardo Botticini; Kohlmann, Osvaldo; Ribeiro, Artur Beltrame

doi:10.2165/00003495-198800356-00018

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Postural hypotension was reported (or its absence could be inferred) in 11 studies (studies 3, 7–12, 14, 18, 19, 22). This occurred in only one doxazosin‐treated patient 17 and in three indoramin‐treated patients 47 . For all selective α 1 ‐blockers and for doxazosin alone, the risk difference was 0.003 (95% CI: ‐0.016, 0.022) and 0.00073 (95% CI: ‐0.013, 0.015), respectively.…”

Section: Resultsmentioning

confidence: 98%

“…The risk difference (event rate in treatment minus event rate in control group) was estimated at 0.08 (95% CI: 0.06, 0.10), which was statistically significant. Only two studies reported any events in this category, and both of these studies used the shorter‐acting agent indoramin, rarely used today 40,47 . Thus, excluding these studies gave a risk difference of zero for the remaining trials.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 27 clinical studies evaluating the use of an α 1 ‐blocking agent in patients with type 2 diabetes, 22 were included in the analysis (Table 2). 17,18,20,29–47 In these studies (published between 1980 and 1995), the number of subjects ranged from 5 to 70, and the study duration ranged from 1 week to 21 months (mean 18.8 weeks).…”

Section: Resultsmentioning

confidence: 99%

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META‐ANALYSIS OF STUDIES USING SELECTIVE α₁‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES

Glanz

Garber

Mancia

et al. 2001

Int J Clinical Practice

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SUMMARYThis meta‐analysis of published studies evaluated the effect of selective α1‐blockers on lipid and carbohydrate profiles and blood pressure (BP) as well as tolerability in patients with hypertension and type 2 diabetes. Publications identified via MEDLINE were used. Text and bibliographies of retrieved articles were examined for additional references. Clinical trials with a randomised comparative structure (placebo and active treatment arms) and controlled studies with other structures were included. Of the 27 citations identified, 22 studies were selected for inclusion, and five were rejected. Efficacy and safety data, lipid and carbohydrate profiles, and study and patient characteristics were extracted by two investigators independently. The mean pooled results showed beneficial effects of selective α1‐blockers on total serum cholesterol (TC), high‐density lipoprotein (HDL) cholesterol, and systolic and diastolic BP. The results also showed doxazosin had beneficial effects on fasting glucose levels, insulin sensitivity, TC, HDL cholesterol, low‐density lipoprotein (LDL) cholesterol, HDL/TC ratio, and systolic and diastolic BP. The risk difference was equivalent between the α1‐blocker group and the control group for postural hypotension or syncope. This meta‐analysis demonstrates a number of favourable effects of therapy with selective α1‐blockers in hypertensive patients with type 2 diabetes. These agents provide an effective modality for reducing BR with favourable effects on lipid, no deterioration in glycaemic control, and little risk of orthostatic hypotension.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

META‐ANALYSIS OF STUDIES USING SELECTIVE α₁‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES

Glanz

Garber

Mancia

et al. 2001

Int J Clinical Practice

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Calcium‐Channel Entry Blocker Therapy for Hypertensive Patients with Concomitant Renal Impairment: A Focus on Isradipine

Frishman

1994

The Journal of Clinical Pharma

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In the treatment of hypertension in renally impaired patients, normalization of blood pressure alone may not be sufficient to prevent significant morbidity to the kidneys. Treatment must reduce pressure in the renal vasculature, otherwise glomerular filtration rate and renal plasma flow will continue to deteriorate. Isradipine a dihydropyridine calcium-channel blocker, has been investigated as a suitable treatment in this setting. Isradipine maintains glomerular filtration rate, preserves or enhances renal plasma flow, decreases renal vascular resistance, maintains or reduces filtration fraction, and exerts a sustained natriuretic effect, all of which may enable isradipine to slow the rate of progression of renal deterioration. In addition, isradipine may decrease proteinuria and may decrease glomerular capillary pressure by dilating both the efferent and afferent arterioles. Unlike older calcium-channel blockers, isradipine exhibits minimal cardiodepressant activity and is not associated with any negative inotropic effects. It is metabolized in the liver and dosage adjustments may not be necessary when administered to patients with renal insufficiency. Isradipine has a favorable renal effect profile and also has several properties that meet the requirements of other patient populations where an extra measure of antihypertensive safety is required, such as diabetics, dialysis patients, and transplant recipients. Side effects with isradipine are usually mild and transient, occurring in a dose-dependent manner.

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Enalapril

Todd¹,

Goa²

1992

Drugs

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Enalapril, an angiotensin converting enzyme (ACE) inhibitor usually administered orally once daily, decreases blood pressure by lowering peripheral vascular resistance without increasing heart rate or output. It is effective in lowering blood pressure in all grades of essential and renovascular hypertension. Patients not responding adequately to enalapril monotherapy usually respond with the addition of a thiazide diuretic (or a calcium antagonist or beta-blocker), and rarely require a third antihypertensive agent. Enalapril is at least as effective as other established and newer ACE inhibitors, and members of other antihypertensive drug classes including diuretics, beta-blockers, calcium antagonists and alpha-blockers, but therapy with enalapril may be less frequently limited by serious adverse effects or treatment contraindications than with other drug classes. The most frequent adverse effect limiting all ACE inhibitor therapy in clinical practice is cough. This favourable profile of efficacy and tolerability, and the substantial weight of clinical experience, explain the increasing acceptance of enalapril as a major antihypertensive treatment and supports its use as logical first-line therapeutic option.

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Hypertension and Diabetes

Cited by 3 publications

References 23 publications

META‐ANALYSIS OF STUDIES USING SELECTIVE α₁‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES

META‐ANALYSIS OF STUDIES USING SELECTIVE α₁‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES

Calcium‐Channel Entry Blocker Therapy for Hypertensive Patients with Concomitant Renal Impairment: A Focus on Isradipine

Enalapril

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Hypertension and Diabetes

Cited by 3 publications

References 23 publications

META‐ANALYSIS OF STUDIES USING SELECTIVE α1‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES

META‐ANALYSIS OF STUDIES USING SELECTIVE α1‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES

Calcium‐Channel Entry Blocker Therapy for Hypertensive Patients with Concomitant Renal Impairment: A Focus on Isradipine

Enalapril

Contact Info

Product

Resources

About

META‐ANALYSIS OF STUDIES USING SELECTIVE α₁‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES

META‐ANALYSIS OF STUDIES USING SELECTIVE α₁‐BLOCKERS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES