Effect of losartan and irbesartan on blood pressure and ISI in female hypertension patients complicated with hyperuricemia

Abstract

Objective To compare the effects of losartan and irbesartan on blood pressure, blood uric acid, insulin sensitivity and insulin resistance in female hypertensive patients complicated with hyperuricemia. Methods From August 2015 to December 2017, 100 females of hypertension complicated with hyperuricemia who hospitalized in the Third People′s Hospital of Ningxia were enrolled in the study.All the patients were divided into two groups according to the random digital table, with 50 cases in each group.The observation group was treated with losartan, and the control group was treated with irbesartan for 8 weeks.The total effective rate and adverse reactions were compared between the two groups.Also the changes of blood pressure, serum uric acid, fasting glucose(FBG), fasting insulin(FINS), high sensitivity C-reactive protein(hs-CRP), insulin sensitivity index(ISI) and insulin resistance index(HOMA-IR) were compared between the two groups after treatment. Results There was no statistically significant difference in the total effective rate between the two groups[92.0%(46/50) vs.90.0%(45/50)](P>0.05). Before treatment, there were no statistically significant differences in blood pressure, serum uric acid, FBG, FINS, hs-CRP, ISI and HOMA-IR between the two groups(all P>0.05). After treatment, the systolic blood pressure and diastolic blood pressure in the two groups were (133.09±10.11)mmHg vs.(131.54±11.01)mmHg and (82.76±6.23)mmHg vs.(83.75±6.88)mmHg, which were lower than those before treatment (observation group: t=19.742, 10.606, control group: t=18.925, -9.956, all P 0.05). After treatment, the serum uric acid in the observation group was lower than that in the control group[(387.21±25.56)μmol/L vs.(429.67±27.44)μmol/L](t=8.006, P<0.05). The hs-CRP, FINS, HOMA-IR, ISI in the observation group were (4.92±1.02)mg/L, (15.92±3.01)mU/L, (1.71±0.24), (1.047±0.095), which in the control group were (4.54±1.00)mg/L, (17.23±3.20)mU/L, (1.65±0.27), (1.140±0.083). After treatment, the hs-CRP, FINS, HOMA-IR in the two groups were decreased(all P<0.05), while ISI was increased (P<0.05). Furthermore, the improvement of FINS, ISI and HOMA-IR in the observation group was better than those in the control group(t=2.109, -5.213, 3.191, all P<0.05). Conclusion Both losartan and irbesartan can improve clinical symptoms, lower blood pressure and improve insulin resistance in female hypertension patients complicated with hyperuricemia, and losartan is more effective than irbesartan. Key words: Hypertension; Hyperuricemia; Female; Blood pressure; Uric acid; Insulin sensitivity; Insulin resistance; Comparative effectiveness research; Losartan; Irbesartan