Yue Yang1, Ri-Bao Wei2, Zi-Cheng Wang3, Na Wang3, Yu-Wei Gao3, Min-Xia Li3, Qiang Qiu3. 1. State Discipline and State Key Laboratory of Kidney Disease (Chinese PLA General Hospital, 2011DAV00088), Beijing 100853, PR China; Medical school of Nankai University, Tianjin 300071, PR China. 2. State Discipline and State Key Laboratory of Kidney Disease (Chinese PLA General Hospital, 2011DAV00088), Beijing 100853, PR China. Electronic address: wrbbj2006@126.com. 3. State Discipline and State Key Laboratory of Kidney Disease (Chinese PLA General Hospital, 2011DAV00088), Beijing 100853, PR China.
Abstract
AIMS: This 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. METHODS: Studies 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. RESULTS: A 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). CONCLUSION: In 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.
AIMS: This study sought to compare the effects of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) on insulin sensitivity (IS) in hypertensivepatients without diabetes. METHODS: Studies on the observation of IS in hypertensivepatients 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 hypertensivepatients without diabetes were analyzed using the fixed effect model and the random effect model. RESULTS: A 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 hypertensivepatients 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). CONCLUSION: In 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 hypertensivepatients without diabetes.