Document Detail


Adrenergic blockade improved insulin resistance in patients with morning hypertension: the Japan Morning Surge-1 Study.
MedLine Citation:
PMID:  19462498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It has been demonstrated that insulin resistance is associated with morning hypertension. We investigated the hypothesis that the lowering of morning blood pressure (BP) can improve insulin resistance in patients with morning hypertension. METHODS: In the present study, 611 treated hypertensive patients with morning hypertension were randomized into either a doxazosin group, for whom a once-daily bedtime dose of doxazosin was added to the current medication regimen, or a control group, who continued their current medication. The homeostasis model assessment of the insulin resistance index (HOMA-IR) was performed at baseline and the 6th month of treatment. The associations between change in HOMA-IR and changes in systolic BP (SBP) measures were assessed by multiple regression analyses with adjustment for covariates. RESULTS: HOMA-IR was significantly decreased in the doxazosin group (2.1 +/- 3.0 to 1.8 +/- 2.6, P = 0.04) but not in the control group. The change in HOMA-IR was significantly associated with the change in morning SBP (r = 0.10, P = 0.02) but not with evening SBP. In multiple regression analysis, the change in HOMA-IR was independently and significantly associated with the change in morning SBP (beta = 0.15, P = 0.016) but not with the change in evening SBP. CONCLUSION: In patients with morning hypertension, specific treatment for morning hypertension with an adrenergic blockade has a beneficial effect on insulin resistance.
Authors:
Seiichi Shibasaki; Kazuo Eguchi; Yoshio Matsui; Joji Ishikawa; Satoshi Hoshide; Shizukiyo Ishikawa; Tomoyuki Kabutoya; Thomas G Pickering; Kazuyuki Shimada; Kazuomi Kario;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  27     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-21     Completed Date:  2009-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1252-7     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Antagonists / administration & dosage,  therapeutic use*
Aged
Aged, 80 and over
Antihypertensive Agents / administration & dosage
Blood Pressure / drug effects
Circadian Rhythm / physiology
Doxazosin / administration & dosage,  therapeutic use*
Drug Administration Schedule
Female
Homeostasis / drug effects
Humans
Hypertension / drug therapy*,  physiopathology*
Insulin / blood
Insulin Resistance / physiology*
Japan
Male
Middle Aged
Sympathetic Nervous System / drug effects,  physiopathology
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Antagonists; 0/Antihypertensive Agents; 11061-68-0/Insulin; 74191-85-8/Doxazosin
Investigator
Investigator/Affiliation:
Shizukiyo Ishikawa / ; Kazuo Eguchi / ; Toru Hashimoto / ; Masato Morinari / ; Satoshi Hoshide / ; Yoko Hoshide / ; Motoyuki Ishiguro / ; Toshio Nakayama / ; Hideo Hirose / ; Naoshi Yamada / ; Akira Yoshimura / ; Makoto Yamashita / ; Masanori Harada / ; Hitoshi Nishimura / ; Ruri Kaneda / ; Yoshio Matsui / ; Seiichi Shibasaki / ; Mitsunobu Murata / ; Joji Ishikawa / ; Yasuyuki Mizumori / ; Yumiko Yoshida / ; Tsutomu Sudo / ; Kazuo Okuhara / ; Yoshiaki Murakami / ; Takeshi Mitsuhashi / ; Takaaki Katsuki /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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