, Volume 27, Issue 5, pp 447–458 | Cite as

Effects of Antihypertensive Drugs on Endocrine Function

  • Eric P. Brass
Review Articles


Pharmacological treatment of hypertension can cause clinically significant alterations in endocrine function through effects on glucose homeostasis, thyroid and parathyroid hormones, adrenal steroid metabolism and reproductive/pituitary physiology. Long term use of thiazide diuretics causes deterioration in glucose tolerance, probably secondary to potassium depletion. Hypoglycaemic complications of β-blockers (mainly the non-selective compounds) can be dramatic, especially in type I diabetics. Clonidine, diazoxide and calcium antagonists have all been associated with deterioration in glucose tolerance and their long term use should be avoided in type II diabetics if possible.

Propranolol lowers T3 levels by decreasing the conversion of T4 to T3. Prazosin causes elevations in T4 and thyroid-stimulating hormone, while sodium nitroprusside use may result in hypothyroidism. Numerous agents are associated with sexual dysfunction, including methyldopa, reserpine, clonidine and spironolactone. Thiazide diuretics may cause hypercalcaemia, particularly in patients with hyperparathyroidism, by decreasing urinary calcium as well as directly influencing bone and gut calcium handling. Conversely, propranolol may decrease circulating parathyroid hormone levels and correct the hypercalcaemia seen in hyperparathyroidism.

Awareness of drug-induced changes in endocrine function will facilitate the rational management of the hypertensive patient.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Adams, P.; Chalmers, T.M.; Hill, L.F. and Truscott, B.: Idiopathic hypercalcaemia and hyperparathyroidism. British Medical Journal 4: 582–585 (1970).PubMedGoogle Scholar
  2. Ahmad, S.: Hydralazine and male impotence. Chest 78: 758 (1980).Google Scholar
  3. Amery, A.; Berthaux, P.; Bulpitt, C.; Deruyttere, M; De-Schaepdryver, A.; Dollery, C.; Fagard, R.; Forette, F.; Hellemans, J.; Lund-Johansen, P.; Mutsers, A. and Tuomilehto, J.: Glucose intolerance during diuretic therapy. Lancet 1: 681–683 (1978).PubMedGoogle Scholar
  4. Arze, R.S.; Ramos, J.M.; Rashid, H.V. and Kerr, J.N.S.: Amenorrhoea, galactorrhoea and hyperprolactinaemia induced by methyldopa. British Medical Journal 283: 194 (1981).PubMedGoogle Scholar
  5. Avery, G.S. (Ed.): Diazoxide: A review of its pharmacological properties and therapeutic use in hypertensive crises. Drugs 2: 78–137 (1971).Google Scholar
  6. Barzune, L.S. and Settser, H.S.: Impingement of various diabetogenic agents upon beta cell responsiveness. Clinical Research 16: 32 (1968).Google Scholar
  7. Bax, N.D.S.; Lennard, M.S. and Tucker, G.T.: Effect of beta-blockers on thyroid hormones. British Medical Journal 281: 1283 (1980).PubMedGoogle Scholar
  8. Beardwood, D.M.; Alder, J.S.; Graham, C.A.; Beardwood, J.T. and Marble, A.: Evidence for a peripheral action of chlorothiazide in normal man. Metabolism 14: 561–567 (1965).PubMedGoogle Scholar
  9. Bengtsson, C.: Impairment of glucose metabolism during treatment with antihypertensive drugs. Acta Medica Scandinavica Suppl. 628: 63–70 (1978).Google Scholar
  10. Bengtsson, C.; Blohme, G. and Waidenstrom, J.: Diabetes mellitus, carbohydrate tolerance and early insulin response to an intravenous glucose injection in a population sample of women and in women with ischaemic heart disease. Acta Medica Scandinavica 549 (Suppl.): 65–74 (1973).Google Scholar
  11. Berglund, G. and Andersson, O.: Beta blockers or diuretics in hypertension. A six year follow-up of blood pressure and metabolic side effects. Lancet 1: 744–747 (1981).PubMedGoogle Scholar
  12. Bohnet, H.G.; Dahlen, H.G.; Wuttke, W. and Schneider, H.P.G.: Hyperprolactinemic anovulatory syndrome. Journal of Clinical and Endocrinological Metabolism 42: 132–143 (1976).Google Scholar
  13. Boyden, T.W.; Nugent, C.A.; Ogihara, T. and Maeda, T.: Reserpine, hydrochlorothiazide and pituitary-gonadal hormones in hypertensive patients. European Journal of Clinical Pharmacology 17: 329–332 (1980).PubMedGoogle Scholar
  14. Brickman, A.S.; Massry, S.G. and Coburn, J.W.: Changes in serum and urinary calcium during treatment with hydrochlorothiazide: Studies on mechanisms. Journal of Clinical Investigation 51: 945–954 (1972).PubMedGoogle Scholar
  15. Bulpitt, C.J. and Dollery, C.T.: Side effects of hypotensive agents evaluated by a self-administered questionnaire. British Medical Journal 3: 485–490 (1973).PubMedGoogle Scholar
  16. Buse, M.G.; Johnson, A.H.; Kupermine, D. and Buse, J.: Effect of α-adrenergic blockade on insulin secretion in man. Metabolism 19: 219–225 (1970).PubMedGoogle Scholar
  17. Carlson, H.E.: Gynecomastia. New England Journal of Medicine 303: 795–799 (1980).PubMedGoogle Scholar
  18. Caro, J.F.; Bejarab, A.; Burke, J.F. and Glennon, J.A.: A possible role for propranolol in the treatment of renal osteodystrophy. Lancet 2: 451–453 (1978).PubMedGoogle Scholar
  19. Caro, J.F. and Besarab, A.: Propranolol therapy for hyperparathyroidism. Lancet 1: 827 (1978).PubMedGoogle Scholar
  20. Caro, J.F.; Castro, J.H. and Glennon, J.A.: Effect of long term propranolol administration on parathyroid hormone and calcium concentration in primary hyperparathyroidism. Annals of Internal Medicine 91: 740–741 (1979).PubMedGoogle Scholar
  21. Cavalierei, R.R. and Pitt-Rivers, R.: The effects of drugs on the distribution and metabolism of thyroid hormones. Pharmacological Reviews 33: 55–80 (1981).Google Scholar
  22. Cerasi, E.; Luft, R. and Efendic, S.: Effect of adrenergic blocking agents on insulin response to glucose infusion in man. Acta Endocrinologica 69: 335–346 (1972).PubMedGoogle Scholar
  23. Charles, M.A. and Danforth, E.: Nonketoacidotic hyperglycemia and coma during intravenous diazoxide therapy in uremia. Diabetes 20: 501–503 (1971).PubMedGoogle Scholar
  24. Cheng, S.C.; Suzuki, K.; Sadee, W. and Harding, B.W.: Effects of spironolactone, canrenone and canrenoate-K on cytochrome P-450, and 11-β and 18-hydroxylation in bovine and human adrenal cortical mitochondria. Endocrinology 99: 1097–1106 (1976).PubMedGoogle Scholar
  25. Coevoet, B.; Desplan, C.; Sebert, J.L.; Makdassi, R.; Andrejak, M.; Gheerbrant, J.M.; Tolani, M.; Calmette, C.; Moukhtar, M.S. and Fournier, A.: Effect of propranolol and metoprolol on parathyroid hormone and calcitonin secretions in uraemic patients. British Medical Journal 280: 1344–1346 (1980).PubMedGoogle Scholar
  26. Conn, J.W.: Hypertension, the potassium ion and impaired carbohydrate tolerance. New England Journal of Medicine 273: 1135–1143 (1965).PubMedGoogle Scholar
  27. Coppula, J.A.; Leonardi, R.G. and Lippman, W.: Ovulatory failure in rats after treatment with brain norepinephrine depletors. Endocrinology 78: 225–228 (1966).Google Scholar
  28. Cruickshank, J.M.: The clinical importance of cardioselectivity and lipophilicity in beta blockers. American Heart Journal 100: 160–178 (1980).PubMedGoogle Scholar
  29. Cryer, P.E.: Glucose counterregulation in man. Diabetes 30: 261–264 (1981).PubMedGoogle Scholar
  30. Davis, G.; Somers, G.; Van Obberghen, E. and Malaisse, W.J.: Calcium antagonists and islet function, I. Inhibition of insulin release by verapamil. Diabetes 24: 547–551 (1975).Google Scholar
  31. Day, J.L.; Simpson, N.; Metcalfe, J. and Page, R.L.: Metabolic consequences of atenolol and propranolol in treatment of essential hypertension. British Medical Journal 1: 77–80 (1979).PubMedGoogle Scholar
  32. Deacon, S.P.; Karunanayake, H. and Barnett, D.: Acebutolol, atenolol and propranolol and metabolic responses to acute hypoglycaemia in diabetics. British Medical Journal 2: 1255–1257 (1977).PubMedGoogle Scholar
  33. Eto, S.; McMillen-Wood, J.; Hutchins, M. and Fleischer, N.: Pituitary 45Ca uptake and release of ACTH, GH and TSH: Effect of verapamil. American Journal of Physiology 226: 1315–1320 (1974).PubMedGoogle Scholar
  34. Faber, J.; Friis, T.; Kirkegaard, C.; Lumholtz, L.B.; Hansen, J.M.; Siersbaek-Nielsen, K.; Skovsted, L. and Theilade, P.: Serum T4, T3 and reverse T3 during treatment with propranolol in hyperthyroidism, L-T4 treated myxedema and in normal man. Hormone and Metabolic Research 11: 34–36 (1979).PubMedGoogle Scholar
  35. Feller, J.M.: Danger of hypoglycaemia with use of propranolol. Medical Journal of Australia 2: 92 (1973).PubMedGoogle Scholar
  36. Franks, S.; Jacobs, H.S.; Martin, N. and Nabarro, J.D.N.: Hyperprolactinemia and impotence. Clinical Endocrinology 8(4): 277–287 (1978).PubMedGoogle Scholar
  37. Friesen, H. and Hwang, P.: Human prolactin. Annual Review of Medicine 24: 251–270 (1973).PubMedGoogle Scholar
  38. Garbus, S.B.; Weber, M.A.; Priest, R.T.; Brewer, D.D. and Hubbell, F.A.: The abrupt discontinuation of antihypertensive treatment. Journal of Clinical Pharmacology 19: 476–486 (1979).PubMedGoogle Scholar
  39. Gerich, J.; Davis, J.; Lorenzi, M.; Rizza, R.; Bohannon, N.; Karam, J.; Lewis, S.; Kaplan, R.; Schultz, T. and Cryer, P.: Hormonal mechanisms of recovery from insulin-induced hypoglycemia in man. American Journal of Physiology 236: E380–E385 (1979).PubMedGoogle Scholar
  40. Gibb, W.E.; Turner, P.; Malpas, J.S. and White, R.J.: Comparison of bethanadine, α-methyldopa and reserpine in essential hypertension. Lancet 2: 275–277 (1970).PubMedGoogle Scholar
  41. Giugliano, D.; Torella, R.; Caciapuoti, F.; Gentile, S.; Verza, M. and Varricchio, M.: Impairment of insulin secretion in man by nifedipine. European Journal of Clinical Pharmacology 18: 395–398 (1980).PubMedGoogle Scholar
  42. Gluskin, L.E.; Strasberg, B. and Shah, J.H.: Verapamil-induced hyperprolactinemia and galactorrhea. Annals of Internal Medicine 95: 66–67 (1981).PubMedGoogle Scholar
  43. Goodner, C.J.; Koerker, C.J.; Werback, J.H.; Toirula, P. and Gale, C.C.: Adrenergic regulation of lipolysis and insulin secretion in the fasted baboon. American Journal of Physiology 224: 534–539 (1973).PubMedGoogle Scholar
  44. Greenblatt, D.J. and Koch-Weser, J.: Gynecomastia and impotence: Complications of spironolactone therapy. Journal of the American Medical Association 223: 82 (1973).PubMedGoogle Scholar
  45. Group, L. and Tutterman, K.J.: Propranolol does not inhibit sulphonylurea-stimulated insulin secretion in patients with noninsulin dependent diabetes mellitus. Acta Endocrinologica 100: 410–415 (1982).Google Scholar
  46. Hansson, L.; Hunyor, S.N.; Julius, S. and Hoobler, S.W.: Blood pressure crises following withdrawal of clonidine (Catapres, Catapresan) with special reference to arterial and urinary catecholamine levels, and suggestions for acute management. American Heart Journal 85: 605–610 (1973).PubMedGoogle Scholar
  47. Harms, H.H.; Gouren, L.; Spoelstra, A.J.G.; Hesse, C. and Verscheer, L.: Blockade of isoprenaline-induced changes in plasma free fatty acids, immunoreactive insulin levels and plasma renin activity in healthy human subjects, by propranolol, pindolol, practolol, atenolol, metoprolol and acebutolol. British Journal of Clinical Pharmacology 5: 19–26 (1978).PubMedGoogle Scholar
  48. Helderman, J.H.; Elahi, D.; Andersen, D.K.; Raizes, G.S.; Tobin, J.D.; Shocken, D. and Andres, R.: Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes 32: 106–111 (1983).PubMedGoogle Scholar
  49. Hermansen, K. and Iversen, J.: Effect of verapamil on pancreatic glucagon release from the isolated, perfused canine pancreas. Scandinavian Journal of Clinical and Laboratory Investigation 37: 139–142 (1977).PubMedGoogle Scholar
  50. Heyma, P.; Larkins, R.G.; Higgenbotham, L. and Ng, K.W.: D-propranolol and dl-propranolol both decrease conversion of 1-thyroxine to 1-triiodothyroxine. British Medical Journal 281: 24–26 (1980).PubMedGoogle Scholar
  51. Hicks, B.H.; Ward, J.D.; Jarrett, R.J.; Keen, H. and Wise, P.: A controlled study of clopamide, clorexolone and hydrochlorothiazide in diabetics. Metabolism 22: 101–109 (1973).PubMedGoogle Scholar
  52. Higgins, B.A.; Nassim, J.R.; Collins, J. and Holb, A.: The effect of bendrofluazide on urine calcium excretion. Clinical Science 27: 457–462 (1964).PubMedGoogle Scholar
  53. Horowitz, J.D. and Goble, A.S.: Drugs and impaired male sexual function. Drugs 18: 206–217 (1979).PubMedGoogle Scholar
  54. Huffman, D.H.; Kampmann, J.P.; Hignite, C.E. and Azarnoff, D.L.: Gynecomastia induced in normal males by spironolactone. Clinical Pharmacology and Therapeutics 24: 465–473 (1978).PubMedGoogle Scholar
  55. Kallen, R.J.; Muhler, J.H. and Lin, H.L.: Hypoglycemia: A complication of treatment of hypertension with propranolol. Clinical Pediatrics 19: 567–568 (1980).PubMedGoogle Scholar
  56. Khan, A.; Camel, G. and Perry, H.M.J.: Clonidine (Catapres): A new antihypertensive agent. Current Therapeutic Research 12: 10–18 (1970).PubMedGoogle Scholar
  57. Khari, J.W.: Impotence from propranolol. Annals of Internal Medicine 85: 258 (1976).Google Scholar
  58. Klimiuk, P.S.; Davies, M. and Adams, P.H.: Primary hyperthyroidism and thiazide diuretics. Postgraduate Medical Journal 57: 80–83 (1981).PubMedGoogle Scholar
  59. Kristensen, B.O.; Steiness, E. and Weeke, J.: Propranolol withdrawal and thyroid hormones in patients with essential hypertension. Clinical Pharmacology and Therapeutics 23: 624–629 (1978).PubMedGoogle Scholar
  60. Kristensen, B.O. and Weeke, J.: Propranolol-induced increments in total and free serum thyroxine in patients with essential hypertension. Clinical Pharmacology and Therapeutics 22: 864–867 (1977).PubMedGoogle Scholar
  61. Kukreja, S.C; Hargis, G.K.; Bowser, E.N.; Henderson, W.J.; Fisherman, E.W. and William, G.A.: Role of adrenergic stimuli in parathyroid hormone secretion in man. Journal of Clinical Endocrinology 40: 478–481 (1975).Google Scholar
  62. Lager, I.; Bluhme, G. and Smith, U.: Effect of cardioselective and non-selective β-blockade on the hypoglycaemic responses in insulin-dependent diabetes. Lancet 1: 458–462 (1979).PubMedGoogle Scholar
  63. Lal, S.; Tolis, G.; Martin, J.B.; Brown, G.M. and Guyder, H.: Effect of clonidine on growth hormone, prolactin, luteinizing hormones, follicle-stimulating hormone and thyroid-stimulating hormone in the serum of normal man. Journal of Clinical Endocrinology and Metabolism 41: 827–836 (1975).PubMedGoogle Scholar
  64. Lawson, A.A.H.: Potassium replacement: When is it necessary? Drugs 21: 354–361 (1981).PubMedGoogle Scholar
  65. Leading Article: Drug-induced diabetes. Lancet 1: 328–329 (1965).Google Scholar
  66. Lee, P.A.; Kelly, M.R. and Wallin, J.D.: Increased prolactin levels during reserpine treatment in hypertensive patients. Journal of the American Medical Association 235: 2316–2317 (1976).PubMedGoogle Scholar
  67. Lewis, P.J.; Petrie, A.; Kohner, E.M. and Dollery, C.T.: Deterioration of glucose tolerance in hypertensive patients on prolonged diuretic treatment. Lancet 2: 564–566 (1976).Google Scholar
  68. Ljunghall, S.; Rudberg, C.; Åkerstrom, G. and Wide, L.: Effects of beta-adrenergic blockade on serum parathyroid hormone in normal subjects and patients with primary hyperparathyroidism. Acta Medica Scandinavica 211: 27–30 (1981).Google Scholar
  69. Lloyd-Mostyn, R.H. and Oram, S.: Modification by propranolol of cardiovascular effects of induced hypoglycaemia. Lancet 1: 1213–1215 (1975).PubMedGoogle Scholar
  70. Lockwood, C.H.; Nichollo, D.M.; Troop, V.L. and Lewis, J.A.: Diazoxide therapy in hypertension. American Journal of the Medical Sciences 246: 312–318 (1963).PubMedGoogle Scholar
  71. Loubataires, A.; Mariani, M.M. and Alric, R.: The action of diazoxide on insulin secretion, medulla-adrenal secretion and the liberation of catecholamines. Annals of the New York Academy of Science 150: 226–239 (1968).Google Scholar
  72. Malluche, H.H.; Meyer-Sabellek, W.; Singer, F.R. and Massry, S.G.: Evidence for a direct effect of thiazides on bone. Mineral and Electrolyte Metabolism 4: 89–96 (1980).Google Scholar
  73. Massara, F.; Strumia, E.; Camanni, F. and Molinatti, G.M.: Depressed tolbutamide-induced response in subjects treated with propranolol. Diabetologia 7: 287–289 (1971).PubMedGoogle Scholar
  74. McBride, J.T.; McBride, M.C. and Viles, P.H.: Hypoglycemia associated with propranolol. Pediatrics 51: 1085–1087 (1973).PubMedGoogle Scholar
  75. McMurtry, R.J.: Propranolol, hypoglycemia and hypertensive crisis. Annals of Internal Medicine 80: 669–670 (1974).PubMedGoogle Scholar
  76. Medical Letter: Effects of drugs in thyroid function tests. Medical Letter 23: 30–32 (1981).Google Scholar
  77. Melander, A.; Ranklev, E.; Sundler, F. and Westgren, U.: Beta2-adrenergic stimulation of thyroid hormone secretion. Endocrinology 97: 332–336 (1975).PubMedGoogle Scholar
  78. Metz, S.A.; Halter, J.B. and Robertson, R.P.: Induction of defective insulin secretion and impaired glucose tolerance by clonidine. Diabetes 27: 554–562 (1978).PubMedGoogle Scholar
  79. Meyers, M.G. and Hope-Gill, H.F.: Effect of d- and dl-propranolol on glucose-stimulated insulin release. Clinical Pharmacology and Therapeutics 25: 303–308 (1979).Google Scholar
  80. Miller, R.A.: Propranolol and impotence. Annals of Internal Medicine 85: 682–683 (1976).PubMedGoogle Scholar
  81. Miller, R.E.: Pancreatic neuroendocrinology: Peripheral neural mechanisms in regulation of the islets of Langerhans. Endocrinology Reviews 2: 471–494 (1981).Google Scholar
  82. Murphy, M.B.; Lewis, P.J.; Kuchner, E.; Schumer, B. and Dollery, C.T.: Glucose intolerance in hypertensive patients treated with diuretics: A fourteen year follow-up. Lancet 2: 1293–1295 (1982).PubMedGoogle Scholar
  83. Newman, R.J. and Salerno, H.R.: Sexual dysfunction due to methyldopa. British Medical Journal 4: 106 (1974).PubMedGoogle Scholar
  84. Nourok, D.S.; Glassock, R.S.; Solomon, D.M. and Maxwell, M.H.: Hypothyroidism following prolonged sodium nitroprusside therapy. American Journal of the Medical Sciences 248: 129–138 (1964).PubMedGoogle Scholar
  85. Okun, R.; Russell, R.P. and Wilson, W.R.: Use of diazoxide with trichlormethiazide for hypertension. Archives of Internal Medicine 112: 862–868 (1963).Google Scholar
  86. Okun, R.; Wilson, W.R. and Gelfand, M.D.: Hyperglycemic effect of hypertension drugs. Journal of Chronic Diseases 17: 31–39 (1964).PubMedGoogle Scholar
  87. Parker, M. and Atkinsen, J.: Withdrawal syndromes following cessation of treatment with antihypertensive drugs. General Pharmacology 13: 79–85 (1982).PubMedGoogle Scholar
  88. Perrild, H.; Hansen, J.M.; Skorsted, L. and Christensen, L.K.: Different effects of propranolol, alprenolol, sotalol, atenolol and metoprolol on serum T3 and serum rT3 in hyperthyroidism. Clinical Endocrinology 18: 139–142 (1983).PubMedGoogle Scholar
  89. Perry, H.M.: Treatment of mild hypertension. Preliminary results of a two year feasibility trend. Circulation Research 40 (Suppl.): 180 (1977).Google Scholar
  90. Pettinger, W.A.: Clonidine, a new antihypertensive drug. New England Journal of Medicine 293: 1179–1180 (1975).PubMedGoogle Scholar
  91. Pita, J.C.; Lippman, M.E.; Thompson, E.B. and Loriaux, D.L.: Interaction of spironolactone and digitalis with the sex-dihydrotestosterone (DHT) receptor of rat ventral prostate. Endocrinology 97: 1521–1527 (1975).PubMedGoogle Scholar
  92. Podolsky, S. and Pattavina, C.G.: Hyperosmolar nonketotic diabetic coma: A complication of propranolol therapy. Metabolism 22: 685–693 (1973).PubMedGoogle Scholar
  93. Popp, D.A.; Shan, S.D. and Cryer, P.E.: Role of epinephrine mediated β-adrenergic mechanisms in hypoglycemia glucose counterregulation and posthypoglycemia hyperglycemia in insulin dependent diabetes mellitus. Journal of Clinical Investigation 69: 315–326 (1982).PubMedGoogle Scholar
  94. Porter, R.H.; Cox, B.G.; Heaney, D.; Hostetter, T.H.; Stinebaugh, B.J. and Suki, W.N.: Treatment of hypoparathyroid patients with chlorthalidone. New England Journal of Medicine 298: 577–581 (1978).PubMedGoogle Scholar
  95. Rassu, S.; Masala, A.; Alagna, S.; Ravasio, P.P. and Langer, M.: Acute effect of atenolol on serum thyroid hormones in hyperthyroid patients. Journal of Endocrinological Investigation 5: 39–41 (1982).PubMedGoogle Scholar
  96. Reid, J.L.; Wing, L.M.H.; Dargie, H.J.; Hamilton, C.A.; Davies, D.S. and Dollery, C.T.: Clonidine withdrawal in hypertension. Lancet 1: 1171–1174 (1977).PubMedGoogle Scholar
  97. Rifka, S.M.; Pita, J.C; Vigersky, R.A.; Wilson, Y.A. and Loriaux, D.L.: Interaction of digitalis and spironolactone with human sex steroid receptors. Journal of Clinical Endocrinology and Metabolism 46: 338–344 (1977).Google Scholar
  98. Robertson, R.P.; Halter, J.B. and Porte, D.: A role for alpha-adrenergic receptors in abnormal insulin secretion in diabetes mellitus. Journal of Clinical Investigation 57: 791–795 (1976).PubMedGoogle Scholar
  99. Robertson, R.P. and Porte, D.: The glucose receptor. A defective mechanism in diabetes mellitus distinct from the beta adrenergic receptor. Journal of Clinical Investigation 52: 870–876 (1973a).PubMedGoogle Scholar
  100. Robertson, R.P. and Porte, D.: Adrenergic modulation of basal insulin secretion in man. Diabetes 22: 1–8 (1973b).PubMedGoogle Scholar
  101. Rowe, J.W.; Tobin, J.D.; Rosa, R.M. and Andres, R.: Effect of experimental potassium deficiency on glucose and insulin metabolism. Metabolism 29: 498–502 (1980).PubMedGoogle Scholar
  102. Saibene, V.; Martinelli, G.; Vasconi, F. and Pozza, G.: Clonidine effect on insulin secretion and lipolysis in man. Acta Diabetologica Latina 15: 192–197 (1978).PubMedGoogle Scholar
  103. Samii, K.; Ciancioni, C.H.; Rottembourg, J.; Bisseliches, F. and Jacobs, C.: Severe hypoglycaemia due to beta-blocking drugs in haemodialysis patients. Lancet 1: 545–546 (1976).PubMedGoogle Scholar
  104. Schein, P.S.; Delellio, R.A.; Kahn, C.R.; Gorden, P. and Kraft, A.R.: Islet cell tumors: Current concepts and management. Annals of Internal Medicine 79: 239–257 (1973).PubMedGoogle Scholar
  105. Shanks, R.G.; Lowe, D.C.; Hadden, D.R.; McDevett, D.G. and Montgomery, D.A.D.: Controlled trial of propranolol in thyrotoxicosis. Lancet 1: 993–994 (1969).PubMedGoogle Scholar
  106. Shasha, S.M.; Shiller, M.; Aryeh, H.B. and Berheim, J.: Effect of pindolol on blood parathyroid hormone concentration. Israel Journal of Medical Sciences 17: 1189–1190 (1981).PubMedGoogle Scholar
  107. Sirek, O.V.; Sirek, A. and Policora, Z.: Inhibition of sulphonylurea-stimulated insulin secretion by beta-adrenergic blockade. Diabetologia 11: 269–272 (1975).PubMedGoogle Scholar
  108. State, R.M.; Smith, L.H.; Wilson, D.M.; Dube, W.J.; Goldsmith, R.J. and Arnaud, C.D.: Hydrochlorothiazide effects on serum calcium and immunoreactive parathyroid hormone concentrations. Annals of Internal Medicine 77: 587–591 (1972).Google Scholar
  109. Steiner, J.; Casser, J.; Mashiter, K.; Dawes, I.; Fraser, T.R. and Breckenridge, A.: Effects of methyldopa on prolactin and growth hormone. British Medical Journal 1: 1186–1188 (1976).PubMedGoogle Scholar
  110. Stessman, J. and Ben-Ishay, D.: Chlorthalidone-induced impotence. British Medical Journal 281: 714 (1980).PubMedGoogle Scholar
  111. Tuck, M.L.; Sowers, J.R.; Fittingoff, D.B.; Fisher, J.S.; Berg, G.J.; Asp, N.D. and Mayes, D.M.: Plasma corticosteroid concentrations during spironolactone administration: Evidence for adrenal biosynthetic blockade in man. Journal of Clinical Endocrinology and Metabolism 52: 1057–1061 (1981).PubMedGoogle Scholar
  112. Turkington, R.W.: Prolactin secretion in patients treated with various drugs. Arch. Int. Med. 130: 349–354 (1972).Google Scholar
  113. Turner, P.: β-Adrenergic receptor blocking drugs in hyperthyroidism. Drugs 7: 48–54 (1974).PubMedGoogle Scholar
  114. Updike, S.J. and Harrington, A.R.: Acute diabetic ketoacidosis — a complication of intravenous diazoxide treatment for refractory hypertension. New England Journal of Medicine 280: 768 (1969).PubMedGoogle Scholar
  115. Velasco, M.; Silva, H.; Murillo, J.; Pellicer, R.; Urbina-Quintam, A. and Hernandez-Pieretti, O.: Effect of prazosin on blood lipids and on thyroid function in hypertensive patients. Journal of Cardiovascular Pharmacology 4 (Suppl.): S225–S227 (1982).PubMedGoogle Scholar
  116. Waal-Manning, H.J.: Can β-blockers be used in diabetic patients? Drugs 17: 157–160 (1979).PubMedGoogle Scholar
  117. Wartofsky, L.; Dimond, R.C.; Noel, G.L.; Frantz, A.G. and Earll, J.M.: Failure of propranolol to alter thyroid iodine release, thyroxine turnover on the TSH and PRL responses to thyrotropin-releasing hormone in patients with thyrotoxicosis. Journal of Clinical Endocrinology and Metabolism 41: 485–490 (1975).PubMedGoogle Scholar
  118. Wartofsky, L. and Burman, K.D.: Alterations in thyroid function in patients with systemic illness: The “euthyroid sick syndrome”. Endocrine Reviews 3: 164–217 (1982).PubMedGoogle Scholar
  119. Webster, W.B. and McConnaughey, M.M.: Clonidine and glucose intolerance. Drug Intell. Clin. Pharm. 16: 325–328 (1982).PubMedGoogle Scholar
  120. Weiler, J.M. and Borondy, P.E.: Effects of benzothiadiazine drugs on carbohydrate metabolism. Metabolism 14: 708–714 (1965).Google Scholar
  121. Wilkens, R.W.: New drugs for the treatment of hypertension. Annals of Internal Medicine 50: 1–10 (1959).Google Scholar
  122. Wolf, F.W.; Parmley, W.W., White, K. and Okun, R.: Drug-induced diabetes. Journal of the American Medical Association 185: 568–574 (1963).Google Scholar
  123. Woods, K.L.; Wright, A.D.; Kendall, M.J. and Block, E.: Lack of effect of propranolol and metoprolol on glucose tolerance in maturity-onset diabetics. Brit. Med, J. 281: 1321 (1980).Google Scholar
  124. Wray, R. and Sutcliffe, S.B.J.: Propranolol-induced hypoglycaemia and myocardial infarction. Brit. Med, J. 2: 592 (1972).Google Scholar
  125. Wright, A.D.; Barber, S.G.; Kendall, M.J. and Poole, P.H.: Beta-adrenoceptor-blocking drugs and blood sugar control in diabetes mellitus. British Medical Journal 1: 159–161 (1979).PubMedGoogle Scholar
  126. Zanoboni, A.; Zanoboni-Muciaccia, W.; Zanussi, C. and Beraldi, R.: Suppression of clonidine-induced release of growth hormone by thyrotropin releasing hormone in humans. Journal of Endocrinological Investigation 2: 347–348 (1979).PubMedGoogle Scholar

Copyright information

© ADIS Press Limited 1984

Authors and Affiliations

  • Eric P. Brass
    • 1
  1. 1.Departments of Medicine and Pharmacology, Division of Clinical PharmacologyUniversity of Colorado Health Sciences CenterDenverUSA

Personalised recommendations