Internal Medicine News - Doxazosin helps fight metabolic syndrome
ORLANDO, FLA. — Doxazosin improves multiple components of the metabolic syndrome in hypertensive ethnic Asian Indians, F.D. Richard Hobbs, M.D., reported at Wonca 2004, the conference of the World Organization of Family Doctors.
This makes doxazosin a particularly attractive first-line antihypertensive agent in this population. Patients whose family origin lies in the Indian subcontinent have an extremely high mortality due to coronary heart disease, and their CHD often occurs in conjunction with the metabolic syndrome, noted Dr. Hobbs, professor of primary care and general practice at the University of Birmingham (England).
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He reported on 160 hypertensive British ethnic Asian Indians in a double blind, 36-week clinical trial at 17 primary care centers in the United Kingdom. They were randomized to antihypertensive therapy with the alpha-1 receptor blocker doxazosin or bendroflumethiazide.
At 21 weeks and 34 weeks, patients on doxazosin had significant reductions in total cholesterol, triglycerides, and serum glucose levels following a standard 2-hour oral glucose tolerance test compared with baseline. The bendroflumethiazide group had increases in total cholesterol, triglycerides, and serum glucose at both time points.
Fasting insulin was significantly lower at 21 and 34 weeks in the doxazosin group than in bendroflumethiazide group. Levels of nonesterified fatty acid particles were significantly lower at 30 minutes and at 2 hours in patients on doxazosin compared with bendroflumethiazide-treated patients at 21 weeks but not at 34 weeks.
Both agents lowered blood pressure to a comparable degree. Amlodipine was required to reach the target diastolic blood pressure of less than 90 mm Hg in 15.4% of the doxazosin group and 22% of patients in the bendroflumethiazide group.
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