Effect of telmisartan in hypertensive patients with diabetes mellitus

Abstract

Objective : Telmisartan, an angiotensin II type 1 receptor blocker (ARB) with partial peroxisome proliferator-activated receptor gamma (PPAR- γ) activity, is expected to improve insulin sensitivity. We retrospectively investigated the effect of telmisartan in hypertensive patients with diabetes. Patients : This study comprised 66 hypertensive patients (39 men and 27 women, aged68.4±9.4years) with diabetes mellitus who received telmisartan (20mg-80mg/day) in our hospital. Methods : Systolic and diastolic blood pressures, HbA_1c, and BMI were compared between before and 6 months after treatment with telmisartan. No patient was treated with insulin. During this period, antidiabetic drugs were not changed in any patient. Results : Telmisartan reduced systolic and diastolic blood pressures significantly (p<0.01). Although BMI was not changed, HbA_1c was significantly improved (p<0.01). In 36 patients who had undergone replacement of other ARBs or ACE- I with telmisartan, either systolic or diastolic pressure decreased significantly (p<0.01).In addition, HbA_1c was improved but it was not significant (p=0.06). Conclusion : Telmisartan improved not only blood pressure but also gluco-metabolic control without weight gain. This improvement of diabetic control may be related to its PPAR- γ activity.