In hypertensive patients, LVH and insulin resistance (IR) often coexist, amplifying development of TOD and HF. Therapeutic strategies should aim BP values, LVH , IR and RAS inhibitors would be "drug of choice" for such combinations. Objective: To compare the effects of an ARB-based regimen with eprosartan and ACEI ramipril on LVH and IR in hypertensives with preserved EF. Methods: 101 hypertensives (48,51% of men; 51,1±0,71 yrs) with LVH and IR were randomly assigned to ramipril (R-gr; n=56, mean dose=15,3mg±1,2 mg/d) or eprosartan (E-gr; n=45, mean dose=850±12,4 mg/d). ABPM, TTE, and HOMAIR were performed (baseline, 6, 12- months). LVMI> 95 g/m2 in women and >115 g/m2 in men identified LVH. Relative wall thickness (RWT >0.42) categorize geometry of Evolution of LV remodeling and HOMA IR. LV remodeling. To define IR was used HOMAIR levels > 2.5. Results: LV remodeling indices have a beneficial evolution in both study groups, but more significant (p<0.05) in the E-gr. After 12 months, number of patients in E-gr, who expressed normal pattern of LV geometry, appears to be almost twice higher compared to R-gr. Both therapeutic regimens have gradually improved HOMAIR values ( p<0.001), but with greater reduction in Egr (p<0.001) (Tab.1) Conclusion: Both drug-regiment progressively improve hypertensive LV geometry and IR indices, but with greater efficiency in the Eprosartan-medicated arm, proba-bly due to additional sympatholytic effect of its moiety.