Metoprolol in Diabetes Mellitus: Effect on Glucose Homeostasis

1980 ◽  
Vol 59 (s6) ◽  
pp. 469s-472s ◽  
Author(s):  
B. N. Garrett ◽  
P. Raskin ◽  
N. M. Kaplan

1. In eight hypertensive diabetic subjects receiving hydrochlorothiazide, glucose homeostasis as measured by the changes in plasma glucose, insulin and glucagon after an oral glucose load was not significantly affected by 8 weeks of therapy with metoprolol. 2. The combination of metoprolol plus hydrochlorothiazide significantly lowered blood pressure in all subjects. 3. Plasma renin activity was suppressed by therapy with metoprolol.

1989 ◽  
Vol 257 (3) ◽  
pp. R647-R652 ◽  
Author(s):  
S. M. Block ◽  
J. E. Pixley ◽  
A. H. Wray ◽  
D. Ray ◽  
K. D. Barnes ◽  
...  

Blood volume restitution after hemorrhage was investigated in lambs in the first week of life. Two groups of nonsplenectomized lambs were bled 10 and 20% of their blood volume at 2%/min while being suspended horizontally in a sling with their legs dependent, and a third group was bled 20% while lying down. Blood pressure fell 8% in the lambs bled both 10 and 20% while lying down and 44% in those bled 20% while being suspended. Blood volume was completely restored in all three groups by 5 h after the hemorrhage, the rate of restitution being equal among the groups. The initial phase of restitution was slower when the lambs were bled while lying down. Vasopressin levels were increased only in the lambs bled 20% of their blood volume while being suspended. Plasma renin activity increased similarly in all groups. Hemorrhage increased plasma glucose but did not change plasma protein and serum osmolality. We conclude that lambs bled up to 20% of blood volume restitute relatively quickly at a rate independent of the volume shed. The position of the animal affects the degree of hypotension, the levels of vasopressin, and the rate of the initial phase of volume restoration.


1975 ◽  
Vol 48 (2) ◽  
pp. 147-151
Author(s):  
C. S. Sweet ◽  
M. Mandradjieff

1. Renal hypertensive dogs were treated with hydrochlorothiazide (8−2 μmol/kg or 33 μmol/kg daily for 7 days), or timolol (4.6 μmol/kg daily for 4 days), a potent β-adrenergic blocking agent, or combinations of these drugs). Changes in mean arterial blood pressure and plasma renin activity were measured over the treatment period. 2. Neither drug significantly lowered arterial blood pressure when administered alone. Plasma renin activity, which did not change during treatment with timolol, was substantially elevated during treatment with hydrochlorothiazide. 3. When timolol was administered concomitantly with hydrochlorothiazide, plasma renin activity was suppressed and blood pressure was significantly lowered. 4. These observations suggest that compensatory activation of the renin-angiotensin system limits the antihypertensive activity of hydrochlorothiazide in renal hypertensive dogs and suppression of diuretic-induced renin release by timolol unmasks the antihypertensive effect of the diuretic.


1984 ◽  
Vol 62 (1) ◽  
pp. 116-123 ◽  
Author(s):  
Ernesto L. Schiffrin ◽  
Jolanta Gutkowska ◽  
Gaétan Thibault ◽  
Jacques Genest

The angiotensin I converting enzyme (ACE) inhibitor enalapril (MK-421), at a dose of 1 mg/kg or more by gavage twice daily, effectively inhibited the pressor response to angiotensin I for more than 12 h and less than 24 h. Plasma renin activity (PRA) did not change after 2 or 4 days of treatment at 1 mg/kg twice daily despite effective ACE inhibition, whereas it rose significantly at 10 mg/kg twice daily. Blood pressure fell significantly and heart rate increased in rats treated with 10 mg/kg of enalapril twice daily, a response which was abolished by concomitant angiotensin II infusion. However, infusion of angiotensin II did not prevent the rise in plasma renin. Enalapril treatment did not change urinary immunorcactive prostaglandin E2 (PGE2) excretion and indomethacin did not modify plasma renin activity of enalapril-treated rats. Propranolol significantly reduced the rise in plasma renin in rats receiving enalapril. None of these findings could be explained by changes in the ratio of active and inactive renin. Water diuresis, without natriuresis and with a decrease in potassium urinary excretion, occurred with the higher dose of enalapril. Enalapril did not potentiate the elevation of PRA in two-kidney one-clip Goldblatt hypertensive rats. In conclusion, enalapril produced renin secretion, which was in part β-adrenergically mediated. The negative short feedback loop of angiotensin II and prostaglandins did not appear to be involved. A vasodilator effect, apparently independent of ACE inhibition, was found in intact conscious sodium-replete rats.


1984 ◽  
Vol 66 (6) ◽  
pp. 659-663 ◽  
Author(s):  
L. T. Bannan ◽  
J. F. Potter ◽  
D. G. Beevers ◽  
J. B. Saunders ◽  
J. R. F. Walters ◽  
...  

1. Sixty-five alcoholic patients admitted for detoxification had blood pressure, withdrawal symptoms, plasma cortisol (PC) and plasma aldosteron (PA) levels, plasma renin activity (PRA), and serum dopamin β-hydroxylase (DBH) levels measured on the first and fourth days after admission. 2. On the morning after admission blood pressure was elevated (>140/90) in 32 patients (49%) and was 160/95mmHg or more in 21 (32%). PRA was initially elevated in 41 patients, PA levels in 14, and 13 patients had raised PC levels. By the fourth day, blood pressure and bio-chemical measures had fallen significantly while urine volume and sodium output, low on admission, had increased significantly. On admission urinary metanephrine levels were raised in four out of the 31 patients who had them measured. 3. The height of both the systolic and diastolic blood pressures was significantly related to the severity of the alcohol. withdrawal symptoms. Of the biochemical parameters measured, PC level correlated with systolic but not diastolic pressure, and urinary volume was inversely correlated with the height of the diastolic pressure. No relationship was found between blood pressure and PRA or PA level. 4. The pressor effect of alcohol withdrawal could be due to sympathetic nervous system overactivity, or possibly to hypercortisolaemia. The first hypothesis seems more likely.


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