氯沙坦治疗老年高血压者高胰岛素血症疗效研究

EFFECTS OF LOSARTAN ON INSULIN RESISTANCE IN ELDERLY PATIENTS WITH ESSENTIAL HYPERTENSION

目的 :了解氯沙坦对老年原发性高血压患者胰岛素抵抗 (IR)的影响。方法 :采用连续样本 ,自身前后对照的研究方法 ,以 18例健康老年人为对照 ,观察 36例单纯高血压患者 (EH组 )服用氯沙坦 5 0mg前及 12周后的平均动脉压 (MAP)、空腹及餐后 2h血糖 (BG)、血胰岛素 (IS)、C肽 (CP)值 ,计算出胰岛素敏感指数 (ISI)。结果 :EH组空腹及餐后 2hIS及CP值均显著高于对照组 ,ISI明显低于对照组 (P <0 0 1) ,经氯沙坦治疗后 ,EH组除MAP显著下降 (P <0 0 1)外 ,空腹及餐后 2hIS值亦明显降低 (P <0 0 5 ) ,ISI显著升高 (P <0 0 5 )。结论 :老年高血压者存在IR ,氯沙坦不仅有良好的降压效果 。

OBJECTIVE: To observe the effects of losartan on insulin resistance (IR) in elderly patients with essential hypertension METHODS: The level of fasting and 2 h postprandial blood glucose (BG), serum insulin (IS), C peptide (CP) and mean arterial pressure (MAP) in 36 elderly patients with hypertension (EH group) were meansured, before and after treatment with 50 mg once daily losartan for 12 weeks And 18 healthy elderly subjects were used as control The insulin sensitive index (ISI) in both groups was calculated and compared RESULTS: The fasting and 2 h postprandial IS and CP level in EH group was significantly higher than those in the control group and conversely the ISI value in EH group was significantly lower than those in control group After treatment with losartan, the MAP, the fasting and 2 h postprandial IS value of EH group were significantly decresed and ISI value was significantly increased CONCLUSION: Losartan not only can effectively decrease IR of EH patients but can also improve IR of elderly patient with hypertension