title: The effect of angiotensin II receptor antagonism with losartan on glucose metabolism and insulin sensitivity.
abstract: OBJECTIVE
  To investigate the metabolic effects of losartan (Cozaar) in patients with essential hypertension.
  
  
  METHODS
  Twenty patients with mild hypertension (office blood pressure > 140/95 mmHg and home diastolic blood pressure > 90 mmHg) were examined in a double-blind, placebo-controlled cross-over study of 4 weeks of treatment with 50-100 mg losartan. The effects on glucose metabolism were assessed by euglycaemic glucose clamp examinations [glucose disposal rate (GDR, mg/kg per min)] and oral glucose-tolerance tests (OGTT).
  
  
  RESULTS
  Supine blood pressure was reduced from 146 +/- 3/90 +/- 3 mmHg on placebo to 134 +/- 4/83 +/- 3 mmHg on losartan and the difference was maintained during 120 min of insulin infusion and glucose clamping. GDR was 6.2 +/- 0.5 mg/kg per min on placebo and 6.4 +/- 0.5 mg/kg per min on losartan. The glucose and insulin responses (the area under the curve) during OGTT were similar with placebo and losartan (0.86 +/- 0.3 versus 0.88 +/- 0.4 and 341 +/- 60 versus 356 +/- 60, respectively; arbitary units). Serum cholesterol was 5.3 +/- 0.2 mmol/l on placebo and 5.1 +/- 0.2 mmol/l losartan treatment. High-density lipoprotein cholesterol and triglycerides were, respectively, 1.1 +/- 0.1 and 1.5 +/- 0.2 mmol/l with placebo, and 1.1 +/- 0.1 and 1.4 +/- 0.1 mmol/l with losartan treatment.
  
  
  CONCLUSIONS
  In mildly hypertensive patients, selective angiotensin II receptor antagonism with losartan for 4 weeks lowers blood pressure at rest and during 120 min of glucose clamping, and has neutral effects on insulin sensitivity, glucose metabolism and serum lipids.
authors.affiliation: Department of Internal Medicine, Ullevaal Hospital, University of Oslo, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Moan
authors.forename: A
authors.initials: A
authors.lastname: Høieggen
authors.forename: I
authors.initials: I
authors.lastname: Seljeflot
authors.forename: T
authors.initials: T
authors.lastname: Risanger
authors.forename: H
authors.initials: H
authors.lastname: Arnesen
authors.forename: S E
authors.initials: SE
authors.lastname: Kjeldsen
mesh_terms: D000328:Adult; D000368:Aged; D000804:Angiotensin II / Q000037:antagonists & inhibitors*; D057911:Angiotensin Receptor Antagonists; D001713:Biphenyl Compounds / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology*; D007328:Insulin / Q000494:pharmacology*; D008055:Lipids / Q000097:blood; D019808:Losartan; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000494:pharmacology*
chemical_list: D057911:Angiotensin Receptor Antagonists; D001713:Biphenyl Compounds; D007093:Imidazoles; D007328:Insulin; D008055:Lipids; D013777:Tetrazoles; D000804:Angiotensin II; D005947:Glucose; D019808:Losartan