Comparison of benazepril and losartan on endothelial function and vascular stiffness in patients with Type 2 diabetes mellitus and hypertension: A randomized controlled trial

J Renin Angiotensin Aldosterone Syst. 2015 Dec;16(4):967-74. doi: 10.1177/1470320315573681. Epub 2015 Mar 17.

Abstract

Introduction: The purpose of this study was to compare the effects of benazepril and losartan on endothelial function and vascular stiffness, in patients with diabetes mellitus and hypertension.

Materials and methods: We included hypertensive diabetic patients with an office systolic blood pressure (BP) ⩾ 130 mmHg and/or diastolic BP ⩾ 80 mmHg. Patients were rolled over to amlodipine for 6 weeks, then we performed C-reactive protein assays, BP measurement and vascular tests; next, patients were randomized to benazepril or losartan. The tests were repeated after 12 weeks.

Results: We randomized 14 patients to benazepril and 16 to losartan. There were no differences in systolic (139 versus 134 mmHg, p = 0.618) and diastolic (82 versus 80 mmHg, p = 0.950) BP at the end of the study. C-reactive protein values were lower in the benazepril group (0.38 versus 0.42 mg/dl, p = 0.020). There was a slightly higher flow-mediated vasodilation (FMD) response in the benazepril group (45% increase, p = 0.057) than in the losartan group (19% increase, p = 0.132). Both central systolic BP (129 versus 123 mmHg, p = 0.934) and carotid-femoral pulse wave velocity (cfPWV) (8.5 versus 8.5 m/s, p = 0.280) were the same between groups.

Conclusions: Hypertensive diabetic patients using benazepril had a greater reduction in C-reactive protein, and a slight improvement in FMD, than those taking losartan.

Keywords: Benazepril; C-reactive protein; blood pressure; comparison study; diabetes mellitus; endothelium; hypertension; losartan; renin-angiotensin system; vascular stiffness; vasodilation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aorta / drug effects
  • Aorta / physiopathology
  • Benzazepines / adverse effects
  • Benzazepines / pharmacology
  • Benzazepines / therapeutic use*
  • Blood Pressure / drug effects
  • C-Reactive Protein
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / physiopathology*
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology*
  • Losartan / adverse effects
  • Losartan / pharmacology
  • Losartan / therapeutic use*
  • Male
  • Middle Aged
  • Pulse Wave Analysis
  • Vascular Stiffness / drug effects*

Substances

  • Benzazepines
  • C-Reactive Protein
  • Losartan
  • benazepril