Study The Effect Of Amlodipine Basylate Tablets Plus Telmisartan Or Plus Hydrochlorothiazide-amiloride On Insulin Resistance In Patients With Essential Hypertension

Objective: It was found that insulin resistance was common in patients with essential hypertension. Majority of hypertensive patients needed joint step-down to control blood pressure to normal.To study the effect of Amlodipine Basylate Tablets plus telmisartan or plus Hydrochlorothiazide-amiloride on insulin resistance in patients with essential hypertension;to dicuss the relationship between serum adiponectin and resistin levels and insulin resistance in patients with hypertension.Methods: 54 patients(age50~79 years,male30,female24)with essential hypertension were randomly divided into two groups, one group of low-dose amlodipine plus Hydrochlorothiazide-amiloride (A group), another group of low-dose amlodipine plus telmisartan (B group). Lifestyle control was used in all patients. Before and after the 18 months therapy, to measure height, weight, waist circumference, hip circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum resistin, serum adiponectin, fasting plasma glucose (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL - C), calculate body mass index (BMI), insulin resistance index (Homa-IR) and waist-hip ratio (WHR). Using t test compared the differences of items between two groups, P <0.05 as statistically significant.Result: 1. Common items about two groupsBefore the therapy, age, height, weight, waist circumference, hip circumference, FPG, FINS, HbA1c, TG, TC, LDL-C, HDL-C, BMI, Homa-IR and WHR of two groups had no statistically significant difference (P> 0.05). After 18 months drug intervention, FINS, Homa-IR of A group were higher than B group, statistically significant (P <0.05). FINS,Homa-IR of two groups were reduced. The difference of A group was not statistically significant (P >0.05). The difference of B group was statistically significant (P <0.05).2.The effect of SBP and DBPBefore and after the therapy, SBP and DBP of two groups had no statistically significant difference (P> 0.05). After 18 months drug intervention, SBP and DBP of two groups decreased, the difference was statistically significant (P <0.05) .3. Serum adiponectin and resistin between the two groupsBefore the therapy, serum adiponectin and resistin of two groups had no statistically significant difference (P> 0.05). After 18 months drug intervention, Serum adiponectin of A group was lower than the B group, serum resistin level was higher than B group, the difference was statistically significant (P <0.05). Before and after the therapy, serum adiponectin increased,serum resistin decreased,the difference of A group was not statistically significant (P> 0.05),the difference of B group was statistically significant (P <0.05) .Conclusions: 1. The effect of blood pressure of low-dose Amlodipine Basylate Tablets plus Hydrochlorothiazide-amiloride and plus telmisartan amlodipine had no significant difference.The improvement on insulin resistance in patients with essential hypertension of low-dose Amlodipine Basylate Tablets plus telmisartan amlodipine is better than plus Hydrochlorothiazide-amiloride.2. The increasement on serum adiponectin in patients with essential hypertension of low-dose Amlodipine Basylate Tablets plus telmisartan amlodipine is better than plus Hydrochlorothiazide-amiloride.3. The decreasement on serum resistin in patients with essential hypertension of low-dose Amlodipine Basylate Tablets plus telmisartan amlodipine is better than plus Hydrochlorothiazide-amiloride.