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Effect of Metformin on Blood Pressure

A Study in Obese Non-Diabetic Patients with Hypertension

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Abstract

Objective: To evaluate the effect of metformin on blood pressure and insulin sensitivity in non-diabetic, moderately obese, hypertensive patients.

Patients and methods: An 8-week double-blind, placebo-controlled randomised study with a 4-week placebo run-in period was performed. Euglycaemic hyperinsulinaemic clamp tests and 24-hour ambulatory blood pressure measurements were performed after the 4-week placebo run-in period and after the 8-week double-blind treatment in patients in either the metformin 1500mg a day (n = 11) or corresponding placebo (n = 10) group.

Results: Metformin administration did not decrease either 24-hour ambulatory or office blood pressure when compared with placebo. The office mean systolic/ diastolic (±standard deviation) blood pressures before and after treatments were 153 (±22)/96 (±4)mm Hg and 155 (±14)/94 (+6)mm Hg in the metformin group, and 153 (±30)/97 (± 9)mm Hg and 149 (± 18)/96 (± 9)mm Hg in the placebo group, respectively. Metformin significantly decreased fasting serum glucose concentrations from 5.7 (± 0.9) to 5.2 (± 0.4) mmol/L (p = 0.04), but did not affect the insulin sensitivity of the patients.

Conclusions: Metformin does not appear to have a place in the treatment of hypertension in non-diabetic individuals, at least in those with mild hypertension.

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References

  1. Ferrannini E, Buzzigoli G, Bonadonna R, et al. Insulin resistance in essential hypertension. N Engl J Med 1987; 317: 350–7

    Article  PubMed  CAS  Google Scholar 

  2. Ferrannini EF, Haffner SM, Stern MP. Essential hypertension: an insulin-resistant state. J Cardiovasc Pharmacol 1990; 15 Suppl. 5: S18–25

    PubMed  CAS  Google Scholar 

  3. Lithell HOL. Effect of antihypertensive drugs on insulin, glucose and lipid metabolism. Diabetes Care 1991; 14: 203–9

    Article  PubMed  CAS  Google Scholar 

  4. Berntorp K, Lindgärd F, Mattiasson I. Long-term effects on insulin sensitivity and sodium transport in glucose-intolerant hypertensive subjects when β-blockade is replaced by captopril treatment. J Hum Hypertens 1992; 6: 291–8

    PubMed  CAS  Google Scholar 

  5. Schafer G. Biguanides: a review of history, pharmacodynamics and therapy. Diabetes Metab 1983; 9: 148–63

    CAS  Google Scholar 

  6. Bailey CJ. Biguanides and NIDDM. Diabetes Care 1992; 15: 755–72

    Article  PubMed  CAS  Google Scholar 

  7. DeFronzo RA, Goodman AM, the Multicenter Metformin Study Group. Efficacy of metformin in patients with noninsulin-dependent diabetes mellitus. N Engl J Med 1995; 333: 541–9

    Article  PubMed  CAS  Google Scholar 

  8. Nosadini R, Avogaro A, Trevisan R, et al. Effect of metformin on insulin-stimulated glucose turnover and insulin binding to receptors in type II diabetes. Diabetes Care 1987; 10: 62–7

    Article  PubMed  CAS  Google Scholar 

  9. DeFronzo RA, Barzilai N, Simonson DC. Mechanism of metformin action in obese and lean noninsulin-dependent diabetic subjects. J Clin Endocrinol Metab 1991; 73: 1294–301

    Article  PubMed  CAS  Google Scholar 

  10. Johnson AB, Webster JM, Sum CF, et al. The impact of metformin therapy on hepatic glucose production and skeletal muscle glycogen synthase activity in overweight type II diabetic patients. Metabolism 1993; 42: 1217–22

    Article  PubMed  CAS  Google Scholar 

  11. Perriello G, Misericordia P, Volpi E, et al. Acute antihyperglycemic mechanisms of metformin in NIDDM: evidence for suppression of lipid oxidation and hepatic glucose production. Diabetes 1994; 43: 920–8

    Article  PubMed  CAS  Google Scholar 

  12. Hother-Nielsen O, Schmitz O, Andersen PH, et al. Metformin improves peripheral but not hepatic insulin action in obese patients with type II diabetes. Acta Endocrinol (Copenh) 1989; 120: 257–65

    CAS  Google Scholar 

  13. Klip A, Leiter LA. Cellular mechanism of action of metformin. Diabetes Care 1998; 13: 696–704

    Article  Google Scholar 

  14. Widen EIM, Eriksson JG, Groop LC. Metformin normalizes nonoxidative glucose metabolism in insulin-resistant normoglycemic first-degree relatives of patients with NIDDM. Diabetes 1992; 41: 354–8

    Article  PubMed  CAS  Google Scholar 

  15. Landin K, Tengborn L, Smith U. Treating insulin resistance in hypertension with metformin reduces both blood pressure and metabolic risk factors. J Intern Med 1991; 229: 181–7

    Article  PubMed  CAS  Google Scholar 

  16. Landin K, Tengborn L, Smith U. Metformin and metoprolol CR treatment in non-obese men. J Intern Med 1994; 235: 335–41

    Article  PubMed  CAS  Google Scholar 

  17. Giugliano D, DeRosa N, DiMaro G, et al. Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women. Diabetes Care 1993; 16: 1387–90

    Article  PubMed  CAS  Google Scholar 

  18. Snorgaard O, Koeber L, Carlsen J. The effect of metformin on blood pressure and metabolism in nondiabetic hypertensive patients. J Intern Med 1997; 242: 407–12

    Article  PubMed  CAS  Google Scholar 

  19. O’Brien E, Atkins N, Mee F, et al. Comparative accuracy of six ambulatory devices according to blood pressure levels. J Hypertens 1993; 11: 673–5

    Article  PubMed  Google Scholar 

  20. De Fronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol 1979; 237: E214–23

    Google Scholar 

  21. Yki-Järvinen H. Action of insulin on glucose metabolism in vivo. Bailliere’s Clin Endocrinol Metab 1993; 7: 903–28

    Article  Google Scholar 

  22. Velazquez EM, Mendoza S, Hamer T, et al. Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperandrogenemia, and systolic blood pressure, while facilitating normal menses and pregnancy. Metabolism 1994; 43: 647–54

    Article  PubMed  CAS  Google Scholar 

  23. Uehara MH, Kohlmann NE, Zanella MT, et al. Metabolic and haemodynamic effects of metformin in patients with type 2 diabetes mellitus and hypertension. Diabetes Obes Metab 2001; 3: 319–25

    Article  PubMed  CAS  Google Scholar 

  24. Berne C, Pollare T, Lithell H. Effects of antihypertensive treatment on insulin sensitivity with special reference to ACE inhibitors. Diabetes Care 1991; 14 Suppl. 4: 39–47

    PubMed  Google Scholar 

  25. DeFronzo RA, Ferranini E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: 173–94

    Article  PubMed  CAS  Google Scholar 

  26. Lithell HO. Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism. Diabetes Care 1991; 14: 203–9

    Article  PubMed  CAS  Google Scholar 

  27. Starke AAR. Determination of insulin sensitivity: methodological considerations. Cardiovasc Pharmacol 1992; 20 Suppl. 11: S17–21

    Article  CAS  Google Scholar 

  28. Boden G, Chen X, DeSantis RA, et al. Effects of age and body fat on insulin resistance in healthy men. Diabetes Care 1993; 16: 728–33

    Article  PubMed  CAS  Google Scholar 

  29. Vuorinen-Markkola H, Yki-Järvinen H. Hyperuricemia and insulin resistance. J Clin Endocrinol Metab 1994; 78: 25–9

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The assistance of Ms Elina Kahra in performing the glucose clamp studies and the office blood pressure measurements is gratefully acknowledged. Also the assistance of Dr Jarno Johansson and Dr Jan Sundell in performing the 24-hour ambulatory blood pressure measurements is acknowledged. We acknowledge Leiras Finland for the donation of the medication for the study.

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Authors and Affiliations

  1. Department of Medicine, Turku University Central Hospital, Turku, FIN-20520, Finland

    Ilkka Kantola

  2. Department of Pharmacology and Clinical Pharmacology, University of Turku, Turku, Finland

    Juha Rouru & Risto Huupponen

  3. Department of Medicine, Tampere University Hospital, Tampere, Finland

    Kimmo Malminiemi

  4. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    Perttu Arkkila

  5. Härkätie Health Centre, Lieto, Finland

    Krista Korhonen & Sirpa Rantanen

Authors
  1. Ilkka Kantola
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  2. Juha Rouru
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  3. Kimmo Malminiemi
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  4. Perttu Arkkila
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  5. Krista Korhonen
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  6. Sirpa Rantanen
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  7. Risto Huupponen
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Correspondence to Ilkka Kantola.

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Kantola, I., Rouru, J., Malminiemi, K. et al. Effect of Metformin on Blood Pressure. Clin. Drug Investig. 22, 347–354 (2002). https://doi.org/10.2165/00044011-200222060-00001

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