title: Effects of antihypertensive drugs losartan and levamlodipine besylate on insulin resistance in patients with essential hypertension combined with isolated impaired fasting glucose.
abstract: The objective of this study was to observe the antihypertensive effect of losartan and levamlodipine besylate on insulin resistance in patients with essential hypertension (EH) combined with isolated impaired fasting glucose (i-IFG). Patients (n=244) were randomly assigned to losartan potassium tablets (50-100 mg per day) or levamlodipine besylate tablets (2.5-5.0 mg per day) for intensive antihypertensive treatment with no lifestyle interventions for 3 years. The changes in fasting plasma glucose, fasting insulin (FINS) and insulin sensitivity index (ISI) from before to after treatment were observed. Blood pressure (BP) in each group was significantly reduced by treatment (P<0.05). After 12 months of treatment, the FINS level in the losartan potassium group was significantly decreased and ISI was significantly increased compared with before treatment (P<0.05) and compared with the levamlodipine besylate group (P<0.05). After 24 and 36 months of treatment, FINS was significantly decreased and ISI was significantly improved in both groups compared with baseline (P<0.05), and there was no difference between the groups (P>0.05). The incidence of new-onset diabetes mellitus was not significantly different between two groups. The antihypertensive effect of losartan and levamlodipine besylate could amoliorate insulin resistance in patients with EH combined with i-IFG. The improvement of insulin resistance by losartan potassium at 12 months might be better than that by levamlodipine besylate; however, after 24 and 36 months of follow-up, both agents significantly alleviated insulin resistance. These results suggest that the effects of these two drugs on insulin resistance are not significantly different.
authors.affiliation: Department of Endocrinology, Southwest Hospital, Third Military Medical University, ChongQing, China.
authors.forename: Wei-Yin
authors.initials: WY
authors.lastname: Xiao
authors.affiliation: Department of Endocrinology, Southwest Hospital, Third Military Medical University, ChongQing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Ning
authors.affiliation: Department of Endocrinology, Southwest Hospital, Third Military Medical University, ChongQing, China.
authors.forename: Ming-Hong
authors.initials: MH
authors.lastname: Tan
authors.affiliation: Department of Endocrinology, Southwest Hospital, Third Military Medical University, ChongQing, China.
authors.forename: Xue-Shu
authors.initials: XS
authors.lastname: Jiang
authors.affiliation: Department of Health Statistics, Third Military Medical University, ChongQing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Health Statistics, Third Military Medical University, ChongQing, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Health Statistics, Third Military Medical University, ChongQing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yi
authors.affiliation: Department of Endocrinology, Southwest Hospital, Third Military Medical University, ChongQing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D000075222:Essential Hypertension; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007333:Insulin Resistance / Q000502:physiology*; D019808:Losartan / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000031:analogs & derivatives* / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; C542574:levamlodipine; D009525:Niacin; D019808:Losartan