Addition of Losartan to Angiotensin-Converting Enzyme Inhibitors Improves Insulin Resistance in Patients With Chronic Heart Failure Treated Without β-Blockers

Background: Angiotensin II and insulin resistance (IR) have clinical implications in the pathophysiology of chronic heart failure (CHF). However, it is still unclear whether the combination of an angiotensin-receptor blocker and angiotensin-converting enzyme inhibitor (ACEI) improves IR in CHF patie...

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Bibliographic Details
Published in:Circulation Journal 2010, Vol.74(11), pp.2346-2352
Main Authors: Ogino, Kazuhide, Kato, Masahiko, Furuse, Yoshiyuki, Kinugasa, Yoshiharu, Kaetsu, Yasuhiro, Mizuta, Einosuke, Sugihara, Shinobu, Ishida, Katsunori, Yanagihara, Kiyotaka, Hisatome, Ichiro, Shigemasa, Chiaki
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Aged
Angiotensin
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Biomarkers - blood
Blood Glucose - metabolism
Chemokine CCL2 - blood
Chronic Disease
Cross-Over Studies
Cytokine
Drug Therapy, Combination
Enalapril - therapeutic use
Female
Heart failure
Heart Failure - blood
Heart Failure - drug therapy
Heart Failure - physiopathology
Humans
Imidazolidines - therapeutic use
Inflammation
Inflammation Mediators - blood
Insulin
Insulin - blood
Insulin Resistance
Interleukin-6 - blood
Japan
Lisinopril - therapeutic use
Losartan - therapeutic use
Male
Middle Aged
Time Factors
Treatment Outcome
Tumor Necrosis Factor-alpha - blood
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Summary:Background: Angiotensin II and insulin resistance (IR) have clinical implications in the pathophysiology of chronic heart failure (CHF). However, it is still unclear whether the combination of an angiotensin-receptor blocker and angiotensin-converting enzyme inhibitor (ACEI) improves IR in CHF patients who do not receive β-blockers. Thus, the aim of the present study was to evaluate the effects of losartan on glucose metabolism and inflammatory cytokines in CHF patients treated with ACEI but not β-blockers. Methods and Results: The effect of losartan treatment for 16 weeks on IR was analyzed in 16 CHF patients in a randomized crossover trial. Insulin level and homeostasis model IR index (HOMA-IR) decreased significantly (P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-10-0395