ObjectiveTo study the effects of isradipine or metoprolol on insulin sensitivity and lipid profiles as well as on blood pressure and umbilical vascular resistance in preeclamptic women in the third trimester of pregnancy.DesignA single-centre, prospective, randomized, doubleblind, double-dummy and parallel-group study.SettingHelsinki University Central Hospital, a tertiary referral centre.PatientsTwenty-four previously healthy pregnant women with normal findings in an oral glucose-tolerance test who were hospitalized for preeclampsia, of whom 17 completed the study.InterventionsBetween 29 and 39 weeks of gestation, measurements were made of insulin sensitivity (the minimal model), magnitude of proteinuria, and the fasting levels of serum uric acid, lipids and lipoproteins. Subsequently, treatment with isradipine 2.5 mg (n= 9) or metoprolol 50 mg (n= 8) twice daily was started, and these women were reinvestigated 5–7 days later. Blood pressure was recorded during 24 h by automated ambulatory blood pressure measurement. Umbilical artery resistance index was measured by Doppler ultrasound.Main outcome measuresInsulin sensitivity, uric acid, degree of proteinuria, lipids and lipoproteins, blood pressure, umbilical artery resistance index.ResultsIsradipine or metoprolol did not affect insulin sensitivity, degree of proteinuria, blood pressure, or the umbilical artery resistance index. Serum uric acid increased in both groups (P< 0.05). High-density lipoprotein2cholesterol increased 15.6% in the isradipine group (P< 0.05), but no significant changes appeared in other lipids and lipoproteins in either group.ConclusionsIn this study, short-term antihypertensive treatment with isradipine or metoprolol in preeclampsia had no detrimental effect on serum lipid and lipoprotein levels or insulin sensitivity.