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- September 5, 2010 |
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"Comparative Effects of Telmisartan and Losartan on Glucose Metabolism in Hypertensive Patients with Metabolic Syndrome"Dr. Guiseppe Rosano (biography)
English - 2005-04-15 - 24 minutes
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Summary :
Angiotensin II receptor blockers (ARBs) are effective antihypertensives that reduce renal and cardiovascular complications in hypertensive diabetic patients and delay the onset of diabetes in non-diabetic hypertensives. Recent data have suggested that the ARB telmisartan may display PPAR gamma agonism and may improve glucose tolerance in animals. This 3-month study compared telmisartan (80 mg/day) with losartan (50 mg/day) using 24-h ambulatory blood pressure monitoring and OGTT in 40 newly diagnosed hypertensive patients with the Metabolic Syndrome. After 3 months fasting plasma glucose was reduced from baseline by 8.3% with telmisartan and increased by 2.9% with losartan (p<0.01). Fasting insulin decreased by 10.2% with telmisartan and by 1.6% with losartan. HOMAi was therefore reduced by 26.1% with telmisartan and increased by 0.7% with losartan (p<0.01). 2-h plasma glucose levels after OGTT decreased by 13.2% with telmisartan and by 2.1% with losartan (p<0.01). 2 hour plasma insulin levels after OGTT decreased by 17.7% with telmisartan and increased by 6.4% with losartan (p<0.01). 24-h mean±SD blood pressure was reduced by both telmisartan and losartan (SBP -13.7±3.4 vs -10.2±3.9 mmHg; DBP -8.8±1.9 vs -4.8±2.7 mmHg, telmisartan vs losartan, p<0.05). No significant correlation between decrease in blood pressure and change in glucose or insulin levels was found. In conclusion, telmisartan, but not losartan, improves glucose metabolism in hypertensive patients with the metabolic syndrome in addition to its anti-hypertensive effect. This effect may depend, at least in part, on specific PPAR gamma agonism by telmisartan.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The benefits of angiotension receptor blockers in diabetes;
- A study comparing telmisartan and losartan on glucose metabolism and blood pressure in hypertensive patients with features of the metabolic syndrome.
Bibliographic references :
Stephen C. Benson, Harrihar A. Pershadsingh, Christopher I. Ho, Amar Chittiboyina, Prashant Desai, Michal Pravenec, Nianning Qi, Jiaming Wang, Mitchell A. Avery, and Theodore W. Kurtz Identification of Telmisartan as a Unique Angiotensin II Receptor Antagonist With Selective PPAR –Modulating Activity Hypertension, May 2004; 43: 993 - 1002.
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