Clinical

Losartan lowers diabetes risk in patients with hypertension and HCV

Last Updated: 2009-08-20 16:56:32 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Treatment with losartan reduces the risk of type 2 diabetes in hypertensive Japanese patients with chronic hepatitis C, according to researchers.

"Data supporting a link between type 2 diabetes mellitus and chronic hepatitis C infection have been reported," Dr. Yasuji Arase at Toranomon Hospital in Tokyo and colleagues write in the September Journal of Medical Virology.

On the basis of earlier reports that angiotensin receptor antagonists can improve insulin sensitivity and glucose and lipid metabolism, the researchers analyzed the cumulative incidence and predictive factors for type 2 diabetes in 80 patients with hepatitis C virus (HCV) infection and hypertension who were treated with losartan. Another 160 patients treated with spironolactone and matched for age and gender served as controls.

At a mean follow-up of slightly more than 5 years, 3 losartan patients and 22 spironolactone patients had developed type 2 diabetes. The fifth-year cumulative appearance rate of type 2 diabetes was 5.9% in the losartan group and 14.0% in the spironolactone group, according to the authors.

On multivariate analysis, hazard ratios for development of type 2 diabetes were 6.10 with spironolactone, 4.31 when histological staging was advanced, 3.28 with steatosis, and 2.47 with pre-diabetes.

"Our results indicate losartan causes about 60% reduction of the risk of type 2 diabetes development compared to spironolactone," the authors said.

Vascular events occurred in 2 losartan-treated patients and 6 spironolactone-treated patients during the observation period.

J Med Virol 2009;81:1584-1590.