Ketanserin in chronic treatment of hypertension in type 2 diabetes mellitus

This study was performed in order to evaluate the effects of ketanserin monotherapy on blood pressure and glucose metabolism in essential hypertensives with type 2 diabetes. Twenty-nine patients, 17 males and 12 females, aged 45 to 78 years, with mild hypertension (DBP greater than or equal to 95 and less than or equal to 105 mmHg) and type 2 diabetes were studied. After a 4 week run-in period on placebo, each patient received ketanserin 20 mg b.i.d. for 6 months, with no modification in previous antidiabetic therapy. SBP, DBP, HR, fasting and post-prandial glycemia were monitored monthly. An oral glucose tolerance test (OGTT), glycosilated hemoglobin (HbA1c), urinary C-peptide, serum electrolytes, creatinine, uric acid, total cholesterol and 24 h protein and glucose urinary excretion were evaluated before and after 3 and 6 months of treatment. Ketanserin significantly reduced both SBP and DBP (p less than 0.005) with no changes in HR. No significant modifications of fasting and post-prandial glycemia, HbA1c and C-peptide were observed. Besides, ketanserin did not affect glucose tolerance, the levels of glucose during the OGTT were not significantly different before and after treatment. None of the patients required any change in antidiabetic therapy. In conclusion, ketanserin was effective in the treatment of mild hypertension in patients with type 2 diabetes. The absence of effects on glucose metabolism makes it an especially interesting drug in such patients