Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
ORIGINAL ARTICLES
Comparative Effects of Telmisartan and Valsartan on Insulin Resistance in Hypertensive Patients with Metabolic Syndrome
Yoshihiko Ichikawa
Author information
JOURNALS OPEN ACCESS

2007 Volume 46 Issue 17 Pages 1331-1336

Details
Abstract

Objective Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that includes hyperglycemia, dyslipidemia, hypertension and increased waist circumference. Individuals with this syndrome are at increased risk for development of cardiovascular disease. Since an insulin-resistance state has a critical role in the development of MetS, there is growing concern about insulin-sensitizing effects of antihypertensives, including angiotensin II receptor blockers (ARBs). Telmisartan has been reported to have an effect on the activity of peroxysome proliferator-activated receptorγ, a well-known target for insulin-sensitizing antidiabetic drugs. The aim of this study was to determine the effects of administration of two different ARBs at low doses (telmisartan at 20 mg/day and valsartan at 40 mg/day) on insulin sensitivity.
Methods Patients with MetS meeting the Japanese criteria were treated with telmisartan or valsartan for 4 weeks in combination with lifestyle modification.
Results A significant reduction in blood pressure was found after 4 weeks of both treatments. The homeostasis model assessment of insulin resistance (HOMA-R) was significantly reduced by telmisartan compared to the baseline value (3.11±2.06 vs 2.56±1.48, p=0.031) but was not significantly changed by valsartan. A statistically significant correlation was found between HOMA-R at baseline and changes in HOMA-R after 4 weeks of treatment only in telmisartan-treated subjects. Body mass index, glycosylated hemoglobin and lipid profile were not changed by either treatment.
Conclusion Our data revealed that treatment with telmisartan even at a low dose improves insulin sensitivity in hypertensive patients with MetS. This ameliorating effect of telmisartan on glucose metabolism clinically deserves to be considered.

Information related to the author
© 2007 by The Japanese Society of Internal Medicine
Previous article Next article
feedback
Top