AbstractBackground The main pharmacodynamic difference between ACE- inhibitors (ACE-i) and AII-receptor antagonists (AII-r) is that ACE-i increase levels of bradykinin, which, in addition to vasodilation, may cause a decrease in insulin resistance. Hypertensive patients with diabetes type II suffering from side effects from ACE-i are frequently changed over to AII-r.Objective 1.To study whether this procedure reduces metabolic control. 2.To study effects on blood pressure and fore arm blood flow (FLOW). 3. To study possible associations between the variables HbA1c and FLOW.Methods A self-controlled sequential comparison is required to address such questions. Sixteen patients were treated with 10 mg of enalapril or equipotent doses of other ACE-i for 6 months, and, subsequently, with the AII-r losartan 50 mg daily for 6 more months. Patients were examined at the outpatient clinic every 4-8 weeks during the trial. FLOW was measured by iridium strain gauge venous occlusion plethysmography.Results Mean arteri...