Effect of Alpha-Adrenergic Blockers, ACE Inhibitors, and Calcium Channel Antagonists on Renal Function in Hypertensive Non-Insulin-Dependent Diabetic Patients

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Abstract
In the present study we investigated the effect of a selective α1-adrenergic blocker (doxazosin), an angiotensin-converting enzyme (ACE) inhibitor (captopril), and a calcium channel antagonist (nifedipine) on renal function in hypertensive non-insulin-dependent diabetic patients. 30 NIDD hypertensive patients (age = 50 ± 3 years; BMI = 30 ± 1 kg/m2) (mean ± SEM) were studied before and after a 12-week period of antihypertensive treatment. Ten patients were treated with doxazosin (Cardura) (2-8 mg once daily or 8 mg b.i.d.), 9 with captopril (Capoten) (25-50 mg b.i.d.), and 11 with nifedipine (Procardia-XL) (30-60 mg once daily). Blood pressure, creatinine clearance, 24-hour urinary protein excretion, fasting plasma glucose concentration and glycosylated hemoglobin were measured before and after drug treatment. Fasting plasma glucose and glycosylated hemoglobin (HbA1c) were similar in all three groups prior to the start of antihypertensive therapy and did not change significantly from baselline in any treatment groups. In the doxazosin group creatinine clearance rose from 99 ± 8 to 122 ± 8 ml/l.73 m2·min (p 2·min (p 2·min (p 2·min (p 2·min), while 24-hour urinary protein excretion decreased from 2.84 ± 0.04 to 1.95 ± 0.03 mg/day/ml/l.73 m2·min. Systolic and diastolic blood pressure were similar in doxazosin (150 ± 3/95 ± 2 mm Hg), captopril (153 ± 3 /93 ± 1), and nifedipine (155 ± 4/93 ± 1) groups prior to the start of antihypertensive therapy and declined to 143 ± 3/84 ± 3 (doxazosin), 139 ± 3/82 ± 3 (captopril), and 141 ± 3/84 ± 1 (nifedipine) mm Hg (all p

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