Irbesartan has no short-term effect on insulin resistance in hypertensive patients with additional cardiometabolic risk factors (i-RESPOND)
Abstract
Intervention studies have shown that angiotensin receptor blockers (ARB) may reduce the incidence of type 2 diabetes mellitus. It is currently unclear whether short-term therapy with ARBs affects metabolic parameters. i-RESPOND, a randomised, controlled, multicentre, double-blind study evaluated the effect of 16 weeks of irbesartan vs. hydrochlorothiazide (HCTZ) on insulin resistance as well as on lipid and inflammatory parameters in hypertensive subjects with metabolic syndrome. Patients received irbesartan (150 mg/d; n = 211) or HCTZ (12.5 mg/d; n = 215), titrated to 300 mg/day and 25 mg/day respectively. In a second part of the study (weeks 16-28), patients initially randomised to irbesartan received additional HCTZ and vice versa. At week 16 both irbesartan and HCTZ had no effect on insulin resistance measured by the Matzuda index and beta-cell function. Similarly, in the second part of the study (week 16-28) no differences between irbesartan and HCTZ with respect to glucose metabolism were observed. However, irbesartan induced beneficial changes in high-sensitivity-C-reactive protein (hs-CRP) (irbesartan: -5.5 +/- 5.2%; HCTZ + 19.9 +/- 6.5%, p = 0.0024) and in urinary albumin/creatinine ratio (ACR) (irbesartan: -13%; HCTZ ...Continue Reading
Associated Clinical Trials
References
The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes
The effect of telmisartan on glucose and lipid metabolism in nondiabetic, insulin-resistant subjects
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