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February 28, 2004American Journal of HypertensionOpen Access

Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration

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Why the study?

Does metformin improve arterial blood pressure and cardiac sympathovagal balance in overweight type 2 diabetic patients?

Population

120 overweight type 2 diabetic patients

Comparison

Metformin 850 mg twice daily + diet for 4 months vs Placebo + diet for 4 months

Design

RCT

Follow-up

4 months

Authors

DMDaniela ManzellaUniversity of Milan

Discussion

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Implication

Metformin does not lower mean arterial pressure in overweight type 2 diabetes; extends evidence for independent autonomic and metabolic benefits.

Key Points

  • This research aims to evaluate the effect of metformin on blood pressure and the cardiac autonomic nervous system in obese type 2 diabetic patients.
  • One hundred twenty overweight type 2 diabetic patients were treated with metformin (850 mg twice daily) or placebo for 4 months.
  • Insulin resistance was assessed using the Homeostasis Model Assessment (HOMA) index.
  • Heart rate variability (HRV) was measured to evaluate cardiac sympathovagal balance.
  • Metformin treatment reduced fasting plasma glucose (P <.05), insulin (P <.05), triglyceride (P <.05), and free fatty acid (FFA) concentrations (P <.03).
  • Metformin improved cardiac sympathovagal balance, indicated by changes in the LF/HF ratio, without affecting mean arterial blood pressure.
  • Delta changes in sympathovagal balance index correlated with changes in plasma FFA concentrations and HOMA index, independent of other variables.

Structured PICO

Does metformin improve arterial blood pressure and cardiac sympathovagal balance in overweight type 2 diabetic patients?

P
Population
120 overweight type 2 diabetic patients
I
Intervention
Metformin 850 mg twice daily + diet for 4 months
C
Comparator
Placebo + diet for 4 months
O
Outcome
Arterial blood pressure (BP) and cardiac sympathetic nervous system (assessed by heart rate variability for cardiac sympathovagal balance)surrogate

Metformin improves cardiac sympathovagal balance and metabolic parameters, but not mean arterial blood pressure, in overweight patients with type 2 diabetes.

Cite This Study

Daniela Manzella (2004) studied this question.

synapsesocial.com/papers/6a20cd1667c00b242d13e667https://doi.org/10.1016/j.amjhyper.2003.11.006
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effect of Insulin and Glucose Infusions on Sympathetic Nervous System Activity in Normal Man1981 · 1,155 citations
  2. 2Insulin as a Vascular and Sympathoexcitatory Hormone1997 · 372 citations
  3. 3Fatty Acids Enhance Vascular α-Adrenergic Sensitivity1995 · 129 citations
  4. 4Treating insulin resistance in hypertension with metformin reduces both blood pressure and metabolic risk factors1991 · 225 citations
  5. 5The Importance of Determining Irreversibly Glycosylated Hemoglobin in Diabetics1981 · 66 citations