Metabolic syndrome and angiotensin II receptor antagonists

Abstract

Aim. To investigate the effects of angiotensin II receptor antagonist irbesartan on blood pressure (BP), tissue insulin sensitivity, carbohydrate and lipid metabolism, cerebral perfusion parameters in patients with arterial hypertension (AH), metabolic syndrome (MS), and Type 2 diabetes mellitus (DM-2). Material and methods. The study included 20 patients with AH only, 20 participants with AH + MS, and 20 individuals with AH + DM-2. At baseline and 24 weeks later, physical examination and measurement of body weight, blood glucose, immune-reactive insulin levels, insulin sensitivity index (intravenous insulin4modified glucose tolerance test) were performed. Cerebral perfusion was assessed by single-photon emission computed tomography with 99mTc-HMPAO. Results. Irbesartan therapy demonstrated good antihypertensive effect: target BP levels were achieved in 80% of AH patients, 70% of AH + MS participants, and 50% of AH + DM-2 individuals. Waist circumference reduced in all participants; blood glucose and lipid levels, initially increased, reduced significantly in AH + MS and AH + CD-2 patients. Blood insulin level, increased at baseline, decreased in AH + MS individuals, and insulin secretion improved in AH + DM-2 patients. Insulin sensitivity improved in all participants, but only in AH + MS it was statistically significant. Irbesartan therapy also improved cerebral perfusion, initially reduced, in all patient groups. Conclusion. Irbesartan demonstrated not only good anihypertensive effectiveness, but also positive metabolic and organo-protective effects

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