Hypoglycemia-Induced Hypertension in a Diabetic Patient on Metoprolol
Authors: A. M.M. Shepherd, M. S. Lin, T. K. Keeton
Journal: Annals of Internal Medicine (1981)

Brief Reports1 March 1981Hypoglycemia-Induced Hypertension in a Diabetic Patient on MetoprololALEXANDER M. M. SHEPHERD, M.D., Ph.D., MIN-SHUNG LIN, M.D., T. KENT KEETON, Ph.D.ALEXANDER M. M. SHEPHERD, M.D., Ph.D., MIN-SHUNG LIN, M.D., T. KENT KEETON, Ph.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-3-357 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMetoprolol is the only cardioselective (β1) beta-adrenergic antagonist approved for use in the United States. This agent may be preferable to nonselective β-adrenergic blocking agents in stressful situations in which nonselective β1 and β2 blockade would permit unopposed epinephrine induced α-adrenergic vasoconstriction and hypertension (1, 2). Because insulin-induced hypoglycemia may result in elevated levels of epinephrine, metoprolol has been recommended for use in diabetic hypertensive patients in preference to propranolol (3, 4). We report a case of severe hypertension induced by hypoglycemia in a diabetic hypertensive patient receiving metoprolol.A 60-year-old man was admitted to hospital with a 20-year history...Reference1. JOHNSSON G. Influence of metoprolol and propranolol on hemodynamic effects induced by adrenaline and physical work. Acta Pharmacol Toxicol (Copenh). 1975;36 (Suppl V):59-68. MedlineGoogle Scholar2. VAN HERWAARDENBINKHORSTFENNISLAAR CRJA. Effects of adrenaline during treatment with propranolol and metoprolol. Br Med J. 1977;1:1029. Letter. CrossrefMedlineGoogle Scholar3. LAGERBLOHMESMITH IGU. Effect of cardioselective and nonselective β-blockade on the hypoglycemic response in insulin-dependent diabetics. Lancet. 1979;1:458-62. CrossrefMedlineGoogle Scholar4. ÖSTMANARNERHAGLUNDJULIN-DANNFELTNOVAEWENNLUND JPKAJA. A cardio-selective beta-blocker (metoprolol) in hypertensive insulin-dependent diabetics. Acta Med Scand (Suppl). 1980;639:29-32. MedlineGoogle Scholar5. PEULERJOHNSON JG. Simultaneous single isotope radioenzymatic assay of plasma norepinephrine, epinephrine and dopamine. Life Sci. 1977;21:625-36. CrossrefMedlineGoogle Scholar6. CLARKESANTIAGOCRYER WJP. Catecholamine and growth hormone release with physiologic decrements in the plasma glucose concentration in normal and diabetic man. Clin Res. 1977;25:561A. Abstract. Google Scholar7. CHRISTENSEN N. Plasma norepinephrine and epinephrine in untreated diabetics during fasting and after insulin administration. Diabetes. 1974;23:1-8. CrossrefMedlineGoogle Scholar8. VON EULERLUFT UR. Effect of insulin on urinary excretion of adrenaline and noradrenalin: studies in ten healthy subjects and in six cases of acromegaly. Metabolism. 1952;1:528-32. MedlineGoogle Scholar9. MCMURTRY R. Propranolol, hypoglycemia, and hypertensive crisis. Ann Intern Med. 1974;80:669-70. Letter. LinkGoogle Scholar10. HANSSONDYMLINGMANHEMHÖKFEET BJPB. Long term treatment of moderate hypertension with the beta1-receptor blocking agent metoprolol: II. Effect of submaximal work and insulin-induced hypoglycaemia on plasma catecholamines and renin activity, blood pressure and pulse rate. Eur J Clin Pharmacol. 1977;11:247-54. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The University of Texas Health Science Center at San Antonio San Antonia, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHypertension in older diabetic patientsBeta-adrenoceptor antagonistsHypertensive crisis precipitated by insulin-induced hypoglycemia with end-stage renal failureDrugs Used to Treat Hypertension, Heart Failure, and Angina PectorisENDOCRINE AND METABOLIC ADVERSE EFFECTS OF NON-HORMONAL AND NON-METABOLIC DRUGSBeta-adrenoceptor antagonistsAge-Related Decline in Autonomic Control of Blood PressureDANGEROUS AND COMMON DRUG INTERACTIONS IN PATIENTS WITH DIABETES MELLITUSPharmacy UpdateMore on Paradoxical Pressor Effects of Nonselective Beta-BlockersMore on paradoxical pressor effects of nonselective beta-blockers.Drug interactions in diabetic patientsDiabetes Mellitusβ-Adrenoceptor Blocking AgentsHypertonie und Diabetes mellitusβ-adrenergic blockade and diabetes mellitus. A reviewAnti-anginal and beta-adrenoceptor blocking drugsAnti-anginal and beta-adrenoceptor blocking drugs 1 March 1981Volume 94, Issue 3Page: 357-358KeywordsEpinephrineHypertensionHypoglycemiaInsulinPharmacologyVasoconstriction Issue Published: 1 March 1981 PDF DownloadLoading ...