Since insulin resistance and/or hyperinsulinemia may contribute to structural changes of the vascular wall, the influence of antihypertensive agents on insulin sensitivity could interfere with the long term outcome of blood pressure reduction. Although it is postulated that increased peripheral circulation due to vasodilating agents improves insulin sensitivity, reflex sympathetic activation elicited by blood pressure reduction may influence insulin sensitivity. Thus we investigated the different effects of an alpha blocker (doxazosin) as well as a direct vasodilation (hydralazine) on insulin sensitivity and on sympathetic function in spontaneously hypertensive rats (SHR). Doxazosin and hydralazine decreased mean arterial pressure to a similar extent. Doxazosin, but not hydralazine decreased steady state blood glucose. Plasma norepinephrine increased in doxazosin and hydralazine treated groups as compared to the control group. Thus, despite their similar effects on blood pressure and plasma norepinephrine, alpha-1 blocker improved insulin sensitivity while the direct vasodilator failed to do so, and this difference is probably related to blockade of the alpha-1 receptor rather than to peripheral vasodilation.