Document Detail


Comparison of the effects of three angiotensin II receptor type 1 blockers on metabolic parameters in hypertensive patients with type 2 diabetes mellitus.
MedLine Citation:
PMID:  20493430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In a previous study involving 18 hypertensive patients with type 2 diabetes mellitus, we found that replacement of valsartan and candesartan by telmisartan significantly improved insulin sensitivity and significantly increased serum adiponectin levels in the patients. We investigated the effects of 3 angiotensin II type 1 receptor blockers (ARBs)-telmisartan, candesartan, and valsartan-on metabolic parameters in hypertensive patients with type 2 diabetes.
METHODS: A total of 308 hypertensive patients with diabetes were enrolled in our multicentre, randomized, open-label study. The patients received 40 mg telmisartan, 8 mg candesartan, or 80 mg valsartan for 3 months, and the data of 227 patients (telmisartan: n=74, candesartan: n=79, and valsartan: n=74) were analysed.
RESULTS: The systolic and diastolic blood pressures significantly decreased in all the groups at the end of the study; the decrease was comparable among the 3 groups. The changes in fasting plasma glucose, fasting insulin, glycated haemoglobin (HbA1c), total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, adiponectin, free fatty acids, high-sensitivity C-reactive protein (hs-CRP), and plasminogen activator inhibitor-1 (PAI-1) were comparable between the 3 groups. Telmisartan and candesartan administration tended to lower urinary albumin excretion.
CONCLUSIONS: Low dose telmisartan had a neutral effect on metabolic dysfunction in hypertensive patients with type 2 diabetes; the effect produced by 40 mg telmisartan was comparable with that of 8 mg candesartan and 80 mg valsartan. Failure to detect metabolic differences among the various ARB treatments could have been due to the low statistical power of the study design.
Authors:
Nobuaki Ozaki; Yoshio Nomura; Hiroshi Sobajima; Kunikazu Kondo; Yutaka Oiso
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-02-18
Journal Detail:
Title:  European journal of internal medicine     Volume:  21     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-08-23     Revised Date:  2012-04-09    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  236-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Japan. n-ozaki@med.nagoya-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adiponectin / blood
Aged
Angiotensin II Type 1 Receptor Blockers / administration & dosage*
Benzimidazoles / administration & dosage*
Benzoates / administration & dosage*
Blood Glucose / drug effects
Blood Pressure / drug effects
C-Reactive Protein / metabolism
Diabetes Mellitus, Type 2 / complications,  drug therapy*,  metabolism
Dose-Response Relationship, Drug
Female
Hemoglobin A, Glycosylated / metabolism
Humans
Hypertension / complications,  drug therapy*,  metabolism
Insulin Resistance
Lipids / blood
Male
Middle Aged
Tetrazoles / administration & dosage*
Treatment Outcome
Valine / administration & dosage,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/ADIPOQ protein, human; 0/Adiponectin; 0/Angiotensin II Type 1 Receptor Blockers; 0/Benzimidazoles; 0/Benzoates; 0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Lipids; 0/Tetrazoles; 137862-53-4/valsartan; 139481-59-7/candesartan; 144701-48-4/telmisartan; 7004-03-7/Valine; 9007-41-4/C-Reactive Protein

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