Efficacy of Losartan Potassium and Benazepril in Hypertensive Patients With Insulin Resistance: Impact on Blood Pressure, Insulin Sensitivity, and Diabetes Risk
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background Hypertension and insulin resistance (IR) often coexist, significantly increasing the risk of type 2 diabetes and cardiovascular disease. IR plays a key role in metabolic syndrome, promoting endothelial dysfunction and impairing glucose metabolism. Angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) are commonly prescribed for hypertension, but their differential effects on insulin sensitivity and diabetes risk remain unclear. This study compares the effects of losartan potassium (LP) (ARBs) and benazepril (ACEIs) on blood pressure control, insulin sensitivity, and metabolic parameters in hypertensive patients with IR. Methods A prospective cohort study was conducted from September 2023 to September 2024 at Khyber Teaching Hospital, Peshawar and Lahore Medical and Dental College, Lahore. A total of 364 hypertensive patients with IR were included. Based on physician-prescribed treatment, patients were categorized into two groups: Group A received benazepril (10 mg/day), and Group B received LP (50 mg/day). Primary outcomes included blood pressure control, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) scores, fasting glucose, and lipid profiles, measured at baseline and regular follow-ups over 12 months. Patient adherence was monitored through self-reports and prescription refill checks. Missing data were handled using multiple imputations. Statistical analyses included independent t-tests, paired t-tests, repeated-measures ANOVA, and multivariate regression models, with a significance level set at p < 0.05. Results Both treatments significantly reduced blood pressure, but LP demonstrated greater efficacy, with superior reductions in systolic (26.4 mmHg vs. 24.7 mmHg) and diastolic (15.3 mmHg vs. 13.6 mmHg) readings (p < 0.05). HOMA-IR scores improved more in the losartan group (1.7 vs. 1.4; p = 0.02), along with a greater decrease in fasting glucose, suggesting a potential protective effect against diabetes development. Lipid profile improvements were comparable between groups. Adherence rates were similar, with a dropout rate of 8.2% and no major adverse events. Conclusions LP was more effective than benazepril in lowering blood pressure and improving insulin sensitivity, which may contribute to a lower diabetes risk in hypertensive patients with IR. A randomized controlled trial with longer follow-up is recommended to confirm these findings and assess long-term metabolic outcomes.
Source: Cureus
DOI: 10.7759/cureus.80833
Authors: Ahmed Chaudhary, Sehar Sehar, Sana Iqbal, Muhammad Noor, Ayesha Faisal, Saddam Hussain, Marym Khan, Khaqan Ahmed, Afsheen Siddiqi, Talha Mazhar
Institutions: Michigan State University, Civil Hospital Karachi, Dow University of Health Sciences, Detroit Medical Center, Sinai Grace Hospital, Liverpool University Hospitals NHS Foundation Trust, CMH Kharian Medical College, Khyber Teaching Hospital, University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust, Shifa International Hospital, Ayub Medical College, Divisional Headquarters Teaching Hospital Mirpur, Saidu Medical College
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4408612226