Does metformin decrease blood pressure in patients with Type 2 diabetes intensively treated with insulin?
Open accessAbstract
Aims We investigated in a double‐blind study whether metformin reduces blood pressure (BP) in patients with Type 2 diabetes intensively treated with insulin. Methods A total of 220 patients with Type 2 diabetes were asked to undergo 24‐h ambulatory BP monitoring (24‐h ABPM). One hundred and eighty‐two gave informed consent. Eighty‐nine were randomized to metformin and 93 to placebo. Thirty‐five subjects dropped out (13 placebo, 22 metformin users); 147 patients underwent a second 24‐h ABPM, 16 weeks after randomization. Results Systolic BP (SBP), diastolic BP (DBP), pulse BP (PP), mean BP (MP) and heart rate (HR) were measured as office BP measurements and as 24‐h ABPM for 24‐h, day and night. Office BP measurements did not differ significantly between the placebo‐ and metformin‐treated groups for any BP measure, but showed a non‐significant trend for SBP reduction with metformin use (mean baseline‐adjusted difference, metformin minus placebo: −4.2 mmHg, 95% CI, −9.9 to +1.5; P = 0.15). The baseline‐adjusted differences of the ambulatory measurements were −0.2 mmHg (95% CI, −2.9 to +2.6) for the 24‐h SBP, and +1.1 mmHg (95% CI, −0.7 to +2.8) for the 24‐h DBP. On the whole, BP differences between metformin‐ and placebo‐treated groups were not statistically significant. The only significant difference was for night‐time PP (baseline‐adjusted difference: −2.2 mmHg; 95% CI, −4.2 to −0.2). These results were not different after adjustment for age and diabetes duration, or for (changes in) body mass index, glycated haemoglobin, insulin dose or plasma homocysteine. Conclusion Metformin does not significantly affect BP in patients with Type 2 diabetes intensively treated with insulin.
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Insulin resistance is related to hypertension in both diabetic and non-diabetic individuals.
“Insulin resistance is related to hypertension in both diabetic and non-diabetic individuals”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [107]
Insulin resistance may contribute to hypertension by increasing sympathetic activity, peripheral vascular resistance, renal sodium retention, and vascular smooth muscle tone and proliferation.
“and may contribute to hypertension by increasing sympathetic activity, peripheral vascular resistance, renal sodium retention [107], and vascular smooth muscle tone and proliferation [108,109].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [107]
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Metformin: An Old But Still the Best Treatment for Type 2 Diabetes
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- Authors
- Wulffelé, M. G., Kooy, A., Lehert, P., Bets, D., Donker, A. J. M., & Stehouwer, C. D. A.
- Affiliations
- Ziekenhuis Bethesda (NL)
- University of Mons (BE)
- Merck B.V. (Netherlands) (NL)
- Maastricht University Medical Centre (NL)
- Corresponding author
- Kooy, A.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2005-06-23
- Volume
- 22
- Issue
- 7
- Pages
- 907-913
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2143033481
- Cited by
- 30
- References
- 52
- Citations by year
- 2024: 1 · 2022: 4 · 2021: 3 · 2020: 1 · 2018: 4 · 2017: 3 · 2016: 1 · 2013: 3
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- green
- research.vumc.nl
- Licence
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- metformin, blood pressure, type 2 diabetes, intensive insulin therapy, ambulatory blood pressure monitoring, systolic blood pressure, diastolic blood pressure, heart rate
- MeSH terms
- Age Factors, Blood Pressure, Diabetes Mellitus, Type 2, Double-Blind Method, Drug Administration Schedule, Female, Heart Rate, Glycated Hemoglobin, Homocysteine, Humans, Hypoglycemic Agents, Insulin, Male, Metformin, Middle Aged, Time Factors, Body Mass Index, Blood Pressure Monitoring, Ambulatory
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