Antihypertensive and Metabolic Effects of Amlodipine in Patients with Non-Insulin-Dependent Diabetes Mellitus:

The aim of this study was to evaluate the antihypertensive efficacy and possible effects on metabolic control of amlodipine in hypertensive diabetic patients. After a washout period of 4 weeks, 28 ambulatory patients with mild essential hypertension and non-insulin-dependent diabetes mellitus received amlodipine 10mg once daily for 12 weeks. Blood pressure was significantly decreased after 2,4,8 and 12 weeks of treatment when compared with basal values. No significant changes in heart rate occurred. A significant decrease in fasting plasma glucose was evident after 12 weeks. A slight but not significant decrease in pre- and postprandial plasma glucose, glycosuria and fructosamine concentrations occurred after 4 and 12 weeks of treatment. Microalbuminuria decreased significantly at the end of the study. No correlation was found between the reduction in microalbuminuria and the reduction in systolic or diastolic blood pressure. Cholesterol concentrations and triglycerides decreased, although only the latter was significant. The results of this study confirm the antihypertensive efficacy of amlodipine in hypertensive diabetic patients, and suggest a favourable influence of this drug on glycaemic and lipid control. The favourable changes in microalbuminuria observed after treatment need further studies to elucidate both the exact mechanisms behind increased microalbuminuria in the hypertensive diabetic state and the factors involved in the reduction.