Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Hypertension
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Hypertension
    ONTARGET Substudy Shows No Benefits for Combination Therapy for Prevention of Vascular Events in High-Risk Patients: Presented at ASH(HYP) - (DGDispatch)
    Amlodipine Plus Valsartan Reduces Blood Pressure Reductions Better Than Monotherapy in Black Patients With Severe Hypertension: Presented at ASH(HYP) - (DGDispatch)
    TopAbstracts in Hypertension 05/14/2008 - (DGNews)
    TopAbstracts in Hypertension 05/07/2008 - (DGNews)
    Kidney Disease Substantially Worsens in One-Fourth of African Americans Despite Hypertension Treatment - (DGNews)

    News archive

     Recent webcasts/CME - Hypertension
    • Improving Outcomes in Hypertension and Congestive Heart Failure: Focus on New Generation ß-Blockers
    • Tackling a Silent Threat: Implications and Management of Peripheral Artery Disease
    • Peripheral Artery Disease: A Highly Prevalent Disease Remains Underdiagnosed and Undertreated
    • Pharmacotherapeutic Treatments for Hypertension Complicated with Proteinuria
      Hypertension in the Elderly

      Webcasts/CME archive

       Recent cases - Hypertension
        Dilation of Renal Artery Stenosis after Administration of Losartan
        Angioedema of the Tongue
        Primary Aldosteronism Caused by a Unilateral Adrenal Adenoma Accompanied by Autonomous Cortisol Secretion
        A Case of Hyperreninemic Hypertension with Bilateral Positive Captopril Renography but without Renovascular Stenosis
        Unusual Sequel of Successful Laparoscopic Unilateral Adrenalectomy in a Hypertensive Adolescent

        Cases archive
          




        my personal edition > hypertension > news
        divider

          E-Mail this DGReview to a colleague

        DGReview


        Metformin May Improve Cardiac Autonomic System Balance in Overweight Patients with Type 2 Diabetes

        A DGReview of :"Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration"
        American Journal of Hypertension

        03/15/2004
        By Keely S. Solomon, Ph.D.


        Metformin may improve cardiac autonomic system balance through its effects on plasma free fatty acids and insulin resistance, according to a new Italian study.

        Hyperinsulinaemia is known to increase cardiovascular mortality in patients with type 2 diabetes due to sympathetic overactivity. Recent reports have suggested that elevated plasma free fatty acid (FFA) concentrations may also contribute to a stimulation of the cardiac autonomic nervous system in these patients.

        Treatment with metformin improves insulin action and lowers plasma FFA concentrations. Therefore, it is possible that metformin may also affect the cardiac autonomic nervous system indirectly.

        To address this possibility, Giuseppe Paolisso, MD, of Second University of Naples, Italy, and colleagues investigated the effects of metformin versus placebo treatment on cardiac autonomic nervous activity in 120 overweight patients with type 2 diabetes (mean age, 57 ± 11 years; 64 males).

        Sixty participants were randomly assigned to placebo and 60 to metformin 850 mg twice daily for a period of 4 months. All patients consumed a weight-stable diet during the study period. Venous blood samples were drawn at the start and end of the trial for evaluation of plasma metabolites. Insulin resistance was assessed by the Homeostasis Model Assessment (HOMA), and cardiac autonomic nervous activity by heart rate variability.

        Metformin treatment was associated with decreases in fasting glucose (P < .05), insulin (P < .05), triglycerides (P < .05), FFA concentrations (P < .03), and HOMA index (P < .03). The researchers also detected a significant improvement in cardiac sympathovagal balance in the metformin group, including increases in RR interval, total power and high frequency (P < .05 for all), and decreases in low frequency (LF; P < .05) and LF/HF ratio (P < .02). Metformin did not improve mean arterial blood pressure.

        In addition, the researchers performed a multivariate analysis with LF/HF as the dependent variable, and gender, changes in HOMA index, plasma FFA, triglyceride, and HbA1c as independent variables. Changes in LF/HF ratio were found to be independently and significantly associated with changes in both plasma FFA level (P < .01) and HOMA index (P < .03).

        "Metformin-related changes in plasma FFA and in insulin resistance may be useful to improve autonomic nervous system balance at the cardiac level but not arterial BP in overweight type 2 diabetic patients," the researchers conclude.

        Am J Hypertens 2004 Mar;17:3:223-7. "Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration"

        E-Mail this DGReview to a colleague   To print, use this version






        All contents Copyright (c) 1995-2008 Doctor's Guide Publishing Limited. All rights reserved.



        The NTK initiative. Physicians helping physicians identify Need-To-Know science
           Feedback
        Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
        Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
        1
        2
        3
        4
        5
        6
        7
        Send