Doxazosin and captopril were equally effective in reducing left ventricular mass (by 23% and 27% respectively, P<0.01) and blood pressure in hypertensive type-1 diabetic patients over 6 months.
RCT (n=33)
Does doxazosin compared to captopril reduce blood pressure and left ventricular mass in hypertensive type-1 diabetic patients?
Doxazosin and captopril are equally effective in reducing blood pressure and left ventricular hypertrophy over 6 months in hypertensive type-1 diabetic patients.
The effect of doxazosin versus captopril on blood pressure, albuminuria, and left ventricular mass was studied in 33 hypertensive type-1 diabetic patients randomized to 6 months treatment with captopril (17 patients, mean daily dose 100 mg) or doxazosin (16 patients, mean daily dose 9 mg). Casual and 24-h ambulatory blood pressure (24hBP) were reduced from 163/95 to 144/83 mm Hg and 152/86 to 145/81 mm Hg, respectively, in the captopril group, and from 160/93 to 145/86 mm Hg and 156/86 to 147/79 mm Hg in the doxazosin group (all P < .05). The achieved 24hBP on treatment was positively associated with pretreatment levels of glycosylated hemoglobin (HbA1c) and plasma atrial natriuretic peptide (r = 0.53 and 0.59, respectively, both P < .01). Albuminuria did not change significantly in either group. Left ventricular hypertrophy was present in 13 patients (7 in the captopril and 6 in the doxazosin group). Left ventricular mass was reduced by an average of 27% and 23%, respectively, in these patients (both P < .01), but did not change significantly in patients without left ventricular hypertrophy. The reduction in left ventricular mass was positively associated with the presence of baseline left ventricular hypertrophy and inversely with dietary sodium intake and achieved casual blood pressure on treatment (R2 = 0.59, P < .001). We conclude that doxazosin and captopril used for 6 months are equally effective in reducing blood pressure and left ventricular hypertrophy in hypertensive type-1 diabetic patients; the antihypertensive effect is closely related to glycemic control; and dietary sodium intake and achieved casual blood pressure after treatment are independent determinants of the reduction in left ventricular mass seen in these patients.
Gerdts et al. (1998) conducted an RCT in hypertensive type-1 diabetes (n=33). doxazosin vs. captopril (mean daily dose 100 mg) was evaluated on blood pressure, albuminuria, and left ventricular mass. Doxazosin and captopril were equally effective in reducing left ventricular mass (by 23% and 27% respectively, P<0.01) and blood pressure in hypertensive type-1 diabetic patients over 6 months.