EFFECTS OF VALSARTANON AND RAMIPRIL ON INSULIN RESISTANCE AND VASCULAR ACTIVE SUBSTANCE IN PATIENTS WITH PRIMARY HYPERTENSION

Objective To study effects of valsartanon and ramipril on insulin resistance and vascular active substance in patients with essential hypertension.Methods 70 patients with essential hypertension were randomized into valsartanon group (n=36) and ramipril group (n=34). Fasting plasma AngⅡ,aldosterone(ALD), endothelin (ET-1), glucose, insulin were measured and insulin sensitivity index (ISI) was calculated, 24 h ambulatory Bp monitor were used in patients with essential hypertension before and 4-week treatment with valsarta non and on ramipril.Results (1)The blood pressure decreased significantly after 4-week treatment with valsartanon and ramipril.In group of valsartan,the systolic blood pressure decreased from (160±13) mmHg to (145±12) mmHg (1 mmHg=0.133 kPa),and the diastolic Bp decreased from (99±8) mmHg to (80±7) mmHg,P0.01.In group of ramipril, the systolic blood pressure decreased from (161±12) mmHg to (144±11) mmHg,and the diastolic Bp decreased from (98±9) mmHg to (79±8) mmHg,P0.01.(2)Valsartanon had the same effects on hypertension as ramipril. especially in reducing of 24 h DBP, and had good T/P ratio than ramipril.(3) Plasma AngⅡand ISI increased,the ALD and ET-1 reduced in valsartan group. Plasma AngⅡ, ISI,ALD and ET-1 reduced in valsartanon group.The index of insulin sensitivity was increace in two groups.Conclusion Valsartanon and ramipril are effective and safe drug of management for patients with essential hypertension,and they might also improved the endothelial function and reduce the insulin resistance state.