Key result
Manidipine improves insulin resistance with less sympathetic activation than amlodipine in diabetic hypertension.
Why the study?
Does manidipine improve metabolic parameters and reduce sympathetic nervous system activation compared to amlodipine in hypertensive patients with diabetes?
Does manidipine improve metabolic parameters and reduce sympathetic nervous system activation compared to amlodipine in hypertensive patients with diabetes?
Manidipine represents a favorable treatment option for hypertensive patients with diabetes due to its positive effects on insulin resistance and lower sympathetic activation compared to amlodipine.
Should not yet change dihydropyridine selection in diabetic hypertension; leaves open confirmation of metabolic advantages in randomized trials.
Antihypertensive treatment of patients with diabetes should include those drugs with a positive effect on metabolic parameters. Most patients with diabetes require at least two antihypertensive agents. Combining a dihydropyridine calcium channel blocker with a renin-angiotensin-aldosterone system inhibitor is a rational approach. However, not all dihydropyridines are equal with respect to their effects on metabolic parameters. Thus, manidipine exerts a positive effect on insulin resistance. However, this effect has not been observed with amlodipine. On the other hand, the excessive activation of sympathetic nervous system has been related with an increase of insulin resistance, pulse pressure, and ankle edema rates. Compared with amlodipine, manidipine activates sympathetic nervous system to a lesser extent. As a result, treatment with manidipine represents a good option in hypertensive patients with diabetes.
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Saiz-Satjes et al. (2018) conducted a review in Hypertension and diabetes. Manidipine vs. Amlodipine was evaluated. Manidipine exerts a positive effect on insulin resistance and activates the sympathetic nervous system to a lesser extent compared with amlodipine in hypertensive patients with diabetes.
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