A meta-analysis of the effects of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers on insulin sensitivity in hypertensive patients without diabetes

Abstract

AimsThis study sought to compare the effects of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) on insulin sensitivity (IS) in hypertensive patients without diabetes. MethodsStudies on the observation of IS in hypertensive patients without diabetes who received ACEI and ARB prior to December 2013 was collected using computer-based retrieval of the PUBMED, EMBASE, and COCHRANE databases. The primary indicators included IS, fasting plasma glucose (FPG), and fasting plasma insulin (FPI). The secondary indicators included systolic blood pressure (SBP) and diastolic blood pressure (DBP). A meta-analysis was performed using the STATA and Review Manager 5.2 software. The effects of these two drugs on IS in hypertensive patients without diabetes were analyzed using the fixed effect model and the random effect model. ResultsA total of 203 cases of patients involved in 4 clinical studies were included. As compared to ARB, ACEI treatment resulted in more effective improvement of IS in hypertensive patients without diabetes (SMD: 0.45, 95% CI 0.17–0.73), although these two drugs did not show significant differences with regards to FPG (WMD: 0.00, 95% CI −0.19–0.20), FPI (WMD: −0.34, 95% CI −1.31–0.63), SBP (WMD: 2.85, 95% CI −1.55–7.24), and DBP (WMD: 0.81, 95% CI −1.12–2.75). ConclusionIn patients showing no significant difference in blood pressure control, the comparison between ACEI and ARB showed that the former type of drug more effectively relieved IS in hypertensive patients without diabetes.