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March 16, 2005Journal of Hypertension

Long-term treatment with losartan versus atenolol improves insulin sensitivity in hypertension: ICARUS, a LIFE substudy

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Why the study?

Does a losartan-based regimen improve insulin sensitivity and peripheral vascular hypertrophy compared to an atenolol-based regimen in hypertensive patients with left ventricular hypertrophy?

Population

70 hypertensive patients with electrocardiographic left ventricular hypertrophy

Comparison

Losartan-based regimen for up to 3 years vs Atenolol-based regimen for up to 3 years

Design

RCT, blinded treatment

Follow-up

3 years

Authors

MOMichael Hecht OlsenPreventive CardiologyEFEigil FossumOslo University HospitalAHAud HøieggenOslo University Hospital

Discussion

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Implication

Losartan better preserves insulin sensitivity and vascular structure than atenolol in LVH hypertension; extends ARB metabolic advantages in RCTs.

Structured PICO

Does a losartan-based regimen improve insulin sensitivity and peripheral vascular hypertrophy compared to an atenolol-based regimen in hypertensive patients with left ventricular hypertrophy?

P
Population
70 hypertensive patients with electrocardiographic left ventricular hypertrophy
I
Intervention
Losartan-based regimen for up to 3 years
C
Comparator
Atenolol-based regimen for up to 3 years
O
Outcome
Minimal forearm vascular resistance (MFVR) measured by plethysmography and insulin sensitivity (M/IG) measured by a 2-h isoglycemic hyperinsulinemic clamp at baseline and after 1, 2 and 3 yearssurrogate

In hypertensive patients with left ventricular hypertrophy, losartan preserves insulin sensitivity and prevents peripheral vascular hypertrophy better than atenolol, potentially explaining the lower incidence of new-onset diabetes seen with losartan.

Cite This Study

Olsen et al. (2005) studied this question.

synapsesocial.com/papers/6a70aff05d37378ac1ddd37chttps://doi.org/10.1097/01.hjh.0000163160.60234.15

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The effect of angiotensin II receptor antagonism with losartan on glucose metabolism and insulin sensitivity1996 · 73 citations
  2. 2A Possible Link Between Endothelial Dysfunction and Insulin Resistance in Hypertension. A LIFE Substudy2000 · 20 citations
  3. 3Relative influence of insulin resistance versus blood pressure on vascular changes in longstanding hypertension. ICARUS, a LIFE sub study2000 · 38 citations
  4. 4Comparison of Effects of Angiotensin I– Converting Enzyme Inhibition and β-Blockade for 2 Years on Function of Small Arteries From Hypertensive Patients1995 · 192 citations
  5. 5Old antihypertensives and new diabetes2004 · 156 citations