Comparison of the effects of losartan and amlodipine on plasma leptin and insulin sensitivity in hypertensive obese patients

ABSTRACT

Aim of this study was to compare the effect of losartan and amlodipine on blood pressure [BP] plasma leptin [L] and insulin sensitivity in obese hypertensive patients. Forty- eight obese patients [body mass index [BMI] >/= 30 kg/m2] with mild to moderate essential hypertension [diastolic blood pressure [DBF] >90 and <110 mmHg, as evaluated with an appropriately sized cuff] aged 30-70 years, were randomized to a losartan [50 mg/day for 12 weeks; n=24] or amlodipine [5 mg/day for 12 weeks; n=24] treatment group after a 2-week wash-out period, After the first 4 weeks of treatment there was a titration with dose-doubling in non responder patients [DBP > 90 mmHg]. At the end of the wash out period and of active treatment period, BP and BMI were evaluated and a venous sample was drawn at the same hour in the morning to evaluate plasma L and Insulin resistance index [HOMA-IR] was calculated. No dietary advice was prescribed. Both losartan and amlodipine significantly decreased BP values and HOMA-IR INDEX with no difference between treatments. However, amlodipine had no effect on L and body weight, while losartan produced a significant reduction in L and BMI. These results suggest that in hypertensive obese subjects, treatment with losartan might offer an advantage over treatment with amlodipine, since losartan may help to improve obesity-related disorders in addition to lowering BP