Objective To investigate the effect of
amlodipine,nifedipine and perindopril on insulin
sensitivity(IS) and blood lipid
of patients with essential hypertension(EH).Methods 105 EH patients were randomly divided into 3 groups:amlodipine group;nifedipine group;
perindopril group.Treatment period lasted for 4 weeks. Before and after treatment, IS was measured by euglycemic insulin clamp technique with glucose metabolism rate (M) as an index of IS.Results Amlodipine,nifedipine and perindopril significantly reduced blood pressure compared with that before treatment( P <0.01). In the EH patients with decreased IS,the M value (mg·kg -1 ·min -1 ) after the use of amlodipine,nifedipine and perindopril was higer than that before treatment(amlodipine: 6.6±1.5 Vs 4.6±0 6, P <0.01;nifedipine:5.2±1.2 Vs 4.4±0.6, P <0.05;perindopril: 6.8±1.6 Vs 4.4±0 6, P <0.01). The increase of M value(mg·kg -1 ·min -1 ), nifedipine (1.2±0.9) were significantly lower than that of amlodipine(2.1±1.1) and perindopril(2.4±1.5), P <0.01, respectively, but no significant difference was found between amlodipine and perindopril( P >0.05).Conclusion Amlodipine and perindopril have beneficial effect on improving insulin
sensitivity in EH patients with decreased insulin sensitivity. The effect of nifedipine on insulin sensitivity is lower than that of amlodipine and perindopril. Blood lipid is not significantly changed after short treatment.