Document Detail


Comparative effects of glibenclamide and metformin on ambulatory blood pressure and cardiovascular reactivity in NIDDM.
MedLine Citation:
PMID:  9135928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effects of chronic glibenclamide and metformin therapy on blood pressure (BP) and cardiovascular responsiveness in patients with NIDDM. RESEARCH DESIGN AND METHODS: Fourteen patients with NIDDM received metformin or glibenclamide for 1 month in a double-blind, randomized crossover study. At the end of each treatment period, patients were tested for forearm vascular responsiveness to intrabrachial arterial infusion of diazoxide (an ATP-sensitive potassium channel opener), acetylcholine, sodium nitroprusside, and norepinephrine, BP responses to intravenous infusions of NE and angiotensin II, BP responses to cold pressor testing and isometric exercise, and 24-h ambulatory BP monitoring. RESULTS: Metformin and glibenclamide produced similar glycemic control. Mean 24-h BPs did not differ between the two groups, but mean 24-h heart rates were significantly lower (75 +/- 6 bpm vs. 80 +/- 6 bpm) on glibenclamide therapy than on metformin. Plasma norepinephrine levels were significantly higher on glibenclamide (6.41 +/- 1.77 vs. 4.26 +/- 1.54 mmol/l, P < 0.01), and systolic BP responses to intravenous norepinephrine and angiotensin II were significantly higher on glibenclamide than on metformin (P < 0.02 and P < 0.05, respectively). Systolic BP responses to cold pressor testing appeared higher on glibenclamide than on metformin, but the difference did not quite achieve statistical significance (P = 0.052). Baseline forearm vascular resistance did not differ between the two drugs, nor did forearm vascular resistance responses to diazoxide, acetylcholine, sodium nitroprusside, and norepinephrine differ. CONCLUSIONS: Glibenclamide therapy is accompanied by greater systolic BP responses to norepinephrine and angiotensin II and higher plasma norepinephrine levels than those that occur on metformin therapy. Lower heart rates on glibenclamide therapy despite evidence of greater sympathetic activity suggests that glibenclamide may have negative chronotropic effects.
Authors:
P Sundaresan; D Lykos; A Daher; T Diamond; R Morris; L G Howes
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Diabetes care     Volume:  20     ISSN:  0149-5992     ISO Abbreviation:  Diabetes Care     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-07-24     Completed Date:  1997-07-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  692-7     Citation Subset:  IM    
Affiliation:
Department of Clinical Pharmacology, University of New South Wales, St. George Hospital, Kogarah, Australia.
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / diagnostic use
Adult
Aged
Angiotensin II / diagnostic use
Blood Glucose / drug effects,  metabolism
Blood Pressure / drug effects*
Cholesterol / blood
Cross-Over Studies
Diabetes Mellitus, Type 2 / blood,  drug therapy*,  physiopathology*
Diazoxide / administration & dosage,  diagnostic use
Double-Blind Method
Female
Forearm / blood supply
Glyburide / therapeutic use*
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Hypoglycemic Agents / therapeutic use*
Infusions, Intra-Arterial
Lipoproteins / blood
Male
Metformin / therapeutic use*
Middle Aged
Nitroprusside / diagnostic use
Norepinephrine / blood,  diagnostic use
Regional Blood Flow / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 0/Lipoproteins; 10238-21-8/Glyburide; 11128-99-7/Angiotensin II; 15078-28-1/Nitroprusside; 364-98-7/Diazoxide; 51-41-2/Norepinephrine; 51-84-3/Acetylcholine; 57-88-5/Cholesterol; 657-24-9/Metformin

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


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