Masuo K, Mikami H, Ohigara T
Gender differences in insulin sensitivity and sympathetic responsiveness in young hypertensives
12th Annual ASH Meeting
Am J Hypertens (Apr) 10:110A 1997

Hypertensives treated with captopril or long-acting nifedipine were compared for effects on insulin, glucose and plasma norepinephrine responses during and oral GTT. After one or two year's treatment, insulin responses, characterized by AUC, were improved both by captopril and nifedipine treatment. AUC for norepinephrine also decreased with captopril treatment but increased with nifedipine.

Comment: There are very few studies examining the long-term effects of either ACEI or CEB on insulin resistance or sympathetic responsiveness, so the data presented here are welcome. They confirm the impression that nifedipine, even in a long-acting preparation, may cause neurohumoral activation, which may be undesirable. It is of interest that the effects on insulin and norepinephrine seem to be directionally different, which suggests that the net impact of nifedipine improves insulin resistance, even though SNS activity is intensified. This suggest that the effect of vasodilation, which may improve glucose and insulin delivery to skeletal muscle, may be more important than SNS activation as a determinant of insulin resistance.

Although the title of the manuscript highlights gender differences, the only positive finding in this regard was a stronger effec of both ACE inhibitors and nifedipine on insulin sensitivity in men vs. women. (Alan Weder, M.D., University of Michigan)

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12th Annual ASH Meeting
H: Special problems : Women
H: Special problems : Obesity, Insulin Resistance