Effect of nifedipine and verapamil on carbohydrate metabolism in hypertensive patients with impaired glucose tolerance

J Cardiovasc Pharmacol. 1987:10 Suppl 10:S195-8.

Abstract

Intracellular Ca2+ influx is an essential step in insulin (I) release. Calcium antagonists are reported to reduce I release in vitro and in patients with impaired glucose tolerance (IGT) during acute administration. Their effects during long-term therapy are still controversial. To evaluate the effects of chronic verapamil (V) and nifedipine (N) on carbohydrate metabolism, 12 hypertensive patients (WHO II; aged 37-64 years) with IGT underwent intravenous glucose tolerance tests (IVGTT) (0.33 g/kg body weight in 3 min), arginine (A) infusion (30 g/30 min), and hypoglycemic stress (regular insulin 0.15 U/kg body weight) during which blood levels of glucose (G), I, growth hormone (GH), glucagon (IRG), and cortisol (C) were measured. The patients were then randomized to V (120 mg b.i.d.) or N (20 mg b.i.d.) treatment and, 1 month later, both IVGTT and A infusion were repeated. Hormone determinations were performed by the radioimmunoassay (RIA) and G by the enzymatic method. The patients were maintained on their usual diet for the duration of the study. The rate of decline of G during IVGTT was expressed as Conard's K coefficient (K; normal values greater than 1.3). I and GH during IVGTT were evaluated as the differences between basal and peak values. I, IRG, and GH during A infusion were analyzed as incremental areas. Our results show that neither V nor N impaired carbohydrate metabolism in hypertensive patients with IGT.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arginine / administration & dosage
  • Blood Glucose / analysis
  • Carbohydrate Metabolism*
  • Glucose Tolerance Test*
  • Growth Hormone / blood
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Hypoglycemia / physiopathology
  • Infusions, Intravenous
  • Middle Aged
  • Nifedipine / therapeutic use*
  • Pancreatic Hormones / blood
  • Random Allocation
  • Verapamil / therapeutic use*

Substances

  • Blood Glucose
  • Pancreatic Hormones
  • Growth Hormone
  • Arginine
  • Verapamil
  • Nifedipine