Effects Of Losartan Potassium And Irbesartan On Blood Pressure And Insulin Sensitivity In Hypertensive Patients With Hyperuricemia

BackgroundHypertension(essential hypertension,EH) is not only the most important risk factor of cardiovascular and cerebrovascular diseases, but also the highest incidence of a disease in the world. Now, more and more people in our country suffer hypertension. There are about 200 million patients with hypertension, moreover, the majority of them are the patients with hyperuricemia. They maybe exist insulin resistance at the same time. Hyperuricemia and insulin resistance are also the important risk factors of cardiovascular and cerebrovascular diseases. It is significant for us to reduce blood pressure,uric acid and improve insulin sensitivities. Nowadays, insulin resistance,hypertension and hyperuricemia of the cardiovascular research field have become the "hot."ObjectiveThe purpose of this research is to observe the effects of losartan potassium and Irbesartan on blood pressure and insulin sensitivity in hypertensive patients with hyperuricemiaMethodsBetween June,2010 and December,2010,70 hypertensive patients with hyperuricemia were enrolledand and randomly divided into two groups. Group A were administrated orally with losartan potassium at a dose of 50 to 100 mg per day for eight weeks and group B were treated with Irbesartan . Before and after treatment,blood pressure (BP),fasting blood glucose (FBG),fasting insulin (FINS), uric acid (UA), high-sensitivity C-reaction protein (hs-CRP), were determined and calculate insulin sensitive index (ISI). The adverse effects were recorded during follow up period. Before treatment, we also observe 35 hypertensive patients without HUA (group C) and 35 normal group (group D) as contrast groups.Results1.Fasting insulin in group A,group B and group C were higher than that in group D, ISI in group A,group B and group C were significantly decreased when compared group D (p <0.05); 2. Fasting insulin in group A and group B were higher than that in group C, ISI in group A and group B were significantly decreased when compared group C(p <0.05); 3. Hs-CRP in group A,group B and group C were higher than that in group D (p <0.05)4. Hs-CRP in group A and group B were higher than that in group C(p <0.05); 5. Eight weeks after treatment, hypertensive patients reached to the target leve(lp <0.05). However, there was no significant difference between group A and group B(p >0.05); 6. Hs-CRP in group A and group B were significantly decreased after treatment (P <0.05); 7.Uric acid was significantly reduced in group A compared to that in group B and that before treatment (p <0.05); 8. Fasting insulin in group A and group B were significantly decreased after treatment , moreover, ISI of patients significantly improved at the end of treatment when compared with that before treatment; ISI of patients in group A significantly improved after treatment when compared with that in group B (p <0.05); 9. In the whole follow up period , only trivial dizzy or fatigue happened in 3 patients of group A and dizzy happened in 3 patients of group B.Conclusions(1).Hypertensive patients exist insulin resistance.(2).Hyperuricemia may aggravate insulin resistance.(3).Inflammatory reaction in hypertensive patients was higher than the normal. (4).Hypertensive patients with hyperuricemia exist more serious insulin resistance when compared with hypertensive patients without hyperuricemia.(5).Losartan potassium and Irbesartan can effectively control blood pressure. (6).Losartan potassium and Irbesartan can effectively reduce hs -CRP and inflammatory reaction .(7).Losartan potassium can effectively reduce uric acid.(8).Losartan potassium and Irbesartan can effectively improve ISI, moreover, Losartan potassium is superior to Irbesartan . (9) Losartan potassium and Irbesartan are safe drugs.