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Effects of Nitrendipine and Hydrochlorothiazide on Postprandial Blood Pressure Reduction and Carbohydrate Metabolism in Hypertensive Patients over 70 Years of Age

1988; Lippincott Williams & Wilkins; Volume: 12; Linguagem: Inglês

10.1097/00005344-198806124-00011

1533-4023

Roné W. M. M. Jansen, Henk J.J. van Lier, W.H.L. Hoefnagels,

Blood Pressure and Hypertension Studies

Recently, it has been recognized that blood pressure (BP) in the elderly may decrease alter a meal or oral glucose loading. Calcium antagonists and diuretics have been advocated as first-line drugs lor the treatment of hypertension in the elderly. It is not known whether these antihypertensive drugs may further deteriorate or improve BP homeostasis alter a meal. Therefore, we studied in a double-blind parallel study the effects of a 12-week treatment with nitrendipine. 20 mg once daily, and hydrochlorothiazide, 50 mg once daily, on BP homeostasis after an oral glucose loading. In addition, the effects of both agents on carbohydrate metabolism were studied. Before treatment, mean BP decreased by 13 + 1 mm Hg(SEM) (10%, p < 0.001) 60 mm after the glucose loading in the nitrendipine group [n− 9, age 73 + 3 (SD) years] and by 9 + 2 (SEM) mm Hg (7%, p < 0.01) in the hydrochlorothiazide group [n− 13, age 76 + 4 (SD) years]. After 12 weeks of treatment, oral glucose loading resulted in mean HP reductions of 7 + 2 mm Hg (6%, p < 0.01) and 4 + 2 mm Hg (4%, not significant) in the nitrendipine and hydrochlorothiazide groups, respectively. In the hydrochlorothiazide group, the area under the curve of plasma glucose was significantly higher after treatment than before (p < 0.03). We conclude that antihypertensive treatment with nitrendipine or hydrochlorothiazide improves HP homeostasis alter an oral glucose loading. In contrast to nitrendipine. 12 weeks of treatment with hydrochlorothiazide slightly impairs carbohydrate metabolism.