Comparison of effects of Yalsartan and Captopril on insulin resistance in essential hypertension

To compare the effects of valsartan and captopril on insulin resistance in essential hypertension. Methods: 54 mild to moderate hypertensive patients with fasting hyperinsulinemia were randomly assigned into two groups receiving either valsartan (Group V; Diovan 80-160mg qd, n =26) or captopril (Group C: Captopril 25-50mg bid, n =28) for 3 months. Blood pressure, serum concentration of fasting insulin (FINS) and glucose (FGLU), 2 hour postprandial blood gluscose and serum insulin (2hGLU and 2hINS) were measured respectively on the first and last day of treatment. 20 healthy subjects were served as a normal controlled group (Group N). Insulin-sensitivity index (ISI) was calculated to evaluate the change of ISR after treatment. ISI was also used to compare the differences of ISR among Group V, Group C and Group N. Results: There was similar efficacy in decreasing blood pressure for valsartan and captopril. There were no significant differences of FGLU among all groups before treatment. In both Group V and Group C 2hGLU, FINS and 2hINS all significantly increased while ISI significantly decreased (P0.01). These parameters all significantly improved after treatment (P0.05), but still did not reach normal level (P 0.05). Conclusions; Both valsartan and captopril can improve insulin sensitivity in essential hypertension. But they can not restore it to the normal level with short-term treatment.