Telmisartan improves vascular function independently of metabolic and antihypertensive effects in hypertensive subjects with impaired glucose tolerance
| Autor: | Harald Sourij, Robert Zweiker, Helga Pressl, Thomas C. Wascher, Michaela Eder, Sabine Perl, Isabella Schmölzer |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Benzoates Impaired glucose tolerance Insulin resistance Double-Blind Method Diabetes mellitus Internal medicine Glucose Intolerance medicine Humans Hypoglycemic Agents Prospective Studies Telmisartan Vascular Diseases Endothelial dysfunction Antihypertensive Agents Aged Cross-Over Studies business.industry Middle Aged medicine.disease Crossover study Endocrinology Blood pressure Losartan Hypertension Benzimidazoles Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | International journal of cardiology. 139(3) |
| ISSN: | 1874-1754 |
| Popis: | Hypertensive patients with IGT have increased risk for cardiovascular disease and progression to diabetes mellitus. Clinical trials suggest that the ARB telmisartan uniquely possesses PPARγ agonistic properties and improves insulin resistance as well as vascular endothelial dysfunction. The aim of the present study was to compare vascular effects of telmisartan and losartan in relation to their metabolic and antihypertensive effects in hypertensive patients with IGT.24 patients were randomised in a double-blind, prospective, cross-over trial. At baseline and after 12 weeks of either treatment an oGTT, and endothelial function testing was performed.Endothelial function improved significantly by telmisartan treatment but not by losartan treatment (FMD; T: 7.9 ± 0.7%, vs B: 6.4 ± 0.8, p0.01; vs L: 6.4 ± 0.6, p0.001) at almost identical antihypertensive effect of both agents. Insulin resistance assessed by HOMA (T: 2.20 ± 0.47 vs B: 3.04 ± 0.60, p0.01; vs L: 3.38 ± 0.84, T vs L p0.05) and ISI120 (T: 0.114 ± 0.003 vs B: 0.092 ± 0.002, p0.001; vs L: 0.090 ± 0.006, T vs L p0.01) improved significantly after telmisartan only, as did glucose tolerance (p0.01). The improvement of the endothelial function observed, significantly depended on pretreatment insulin resistance but was independent of improvements of insulin resistance, blood pressure or glucose tolerance.In hypertensive patients with IGT telmisartan compared to losartan improved endothelial function and insulin resistance independently, supporting the hypothesis that glucometabolic and vascular insulin resistance are differentially regulated. |
| Databáze: | OpenAIRE |
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