Which is stronger losartan or lisinopril
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Comparative Strength of Losartan and Lisinopril in Hypertension Treatment
Blood Pressure Reduction: Losartan vs. Lisinopril
Both losartan and lisinopril are effective in reducing blood pressure in patients with hypertension. A study comparing these two medications found that both significantly reduced systolic blood pressure (SBP) and diastolic blood pressure (DBP). Specifically, lisinopril reduced SBP by an average of 20.2 mmHg and DBP by 15.2 mmHg, while losartan reduced SBP by 17.2 mmHg and DBP by 12.3 mmHg. The differences in blood pressure reduction between the two drugs were not statistically significant, indicating that both medications are similarly effective in managing hypertension.
Insulin Sensitivity: Lisinopril's Advantage
When it comes to insulin sensitivity, lisinopril appears to have an edge over losartan. In the same study, lisinopril significantly increased glucose infusion rate (GIR), an indicator of insulin sensitivity, by 1.5 mg/min/kg, whereas losartan only increased GIR by 0.42 mg/min/kg, which was not statistically significant. This suggests that lisinopril may be more beneficial for hypertensive patients who are also concerned about insulin sensitivity.
ACE2 Expression: Implications for COVID-19
Another aspect to consider is the effect of these medications on ACE2 expression, which is relevant in the context of COVID-19. Research has shown that lisinopril increases ACE2 protein levels in various tissues, which could potentially influence the transmission and pathogenesis of SARS-CoV-2. In contrast, losartan did not increase ACE2 levels and even decreased ACE2 gene expression when combined with lisinopril. This interaction suggests that the choice between these medications could have implications beyond blood pressure management, particularly in the context of the ongoing pandemic.
Cardiomyopathy in Duchenne Muscular Dystrophy: No Significant Difference
In the treatment of cardiomyopathy (CM) in boys with Duchenne muscular dystrophy (DMD), both lisinopril and losartan have been found to be equally effective. A randomized, double-blind trial showed that both medications significantly improved ejection fraction (EF) over a one-year period, with no significant difference between the two groups. This indicates that either medication can be used effectively for managing CM in DMD patients.
Conclusion
In summary, both losartan and lisinopril are effective in reducing blood pressure in hypertensive patients, with no significant difference in their efficacy. However, lisinopril has an advantage in improving insulin sensitivity and increasing ACE2 expression, which may have additional implications for patients with concerns about insulin resistance or COVID-19. For the treatment of cardiomyopathy in DMD, both medications are equally effective. Therefore, the choice between losartan and lisinopril may depend on individual patient needs and specific health considerations.
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