Nitrendipine and metabolic balance.

Abnormalities of glucose and lipoprotein metabolism have frequently been found in hypertensive patients in both epidemiological and clinical studies. Reduction of blood pressure favorably affects the rate of cardiovascular diseases mainly when concomitant with a decrease in glucose and lipid serum levels. For these reasons antihypertensive drugs without untoward metabolic side effects should be preferred, particularly in hypertensive patients with metabolic impairment. Nitrendipine, a dihydropiridine derivative, like other calcium-entry blockers, has been proved not to deteriorate fasting glucose (75 +/- 12 vs. 75 +/- 10 mg/dl) and serum insulin (8.5 +/- 3 vs. 10.8 +/- 5 microU/ml) levels. Glucose and insulin response to an oral carbohydrate challenge (glucose % removal rate 1.4 +/- 0.2 vs. 1.5 +/- 0.3%/min; incremental area for serum insulin 955 +/- 279 vs. 905 +/- 458 microU/ml/min), serum cholesterol (192 +/- 33 vs. 200 +/- 43 mg/dl), triglyceride (83 +/- 57 vs. 84 +/- 37 mg/dl) and high-density lipoprotein cholesterol (46 +/- 9 vs. 50 +/- 14 mg/dl) were not affected as well. It is therefore possible to conclude that nitrendipine may be safely prescribed when the antihypertensive activity of a calcium-entry blocker is required.