Document Detail


Telmisartan, an angiotensin II type 1 receptor blocker, improves coronary microcirculation and insulin resistance among essential hypertensive patients without left ventricular hypertrophy.
MedLine Citation:
PMID:  18633172     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension and insulin resistance are associated with reduced coronary vasodilatory capacity, possibly caused by structural changes in the coronary resistance vessels. The goal of this study was to compare the effect of an angiotensin receptor blocker (ARB) with that of a calcium channel blocker (CCB) on coronary flow reserve and insulin resistance among essential hypertensive patients without left ventricular hypertrophy. A total of 40 consecutive essential hypertensive patients were randomized to daily 40 mg telmisartan or 20 mg nifedipine coat-core treatment. Coronary flow velocity reserve (CFVR) measurement using transthoracic Doppler echocardiography and blood tests were performed before and after 12 weeks of treatment. At baseline, blood pressure, CFVR, and homeostasis model assessment of insulin resistance (HOMA-IR) were not significantly different between the two groups. At the end of the treatment period, the telmisartan and nifedipine groups exhibited similar declines in blood pressure. CFVR was improved in the telmisartan group (2.4+/-0.4 to 2.9+/-0.4; p<0.01), but there was no difference in the nifedipine group (2.5+/-0.3 to 2.5+/-0.3; n.s.). HOMA-IR was improved in the telmisartan group (3.1+/-1.1 to 1.6+/-0.7; p<0.01), but there was no difference in the nifedipine group (2.8+/-1.1 to 2.4+/-0.7; n.s.). In conclusion, this study demonstrates that antihypertensive therapy with telmisartan, but not nifedipine, has a beneficial effect on coronary microcirculation and insulin resistance among essential hypertensive patients.
Authors:
Toshihide Hinoi; Yasuyuki Tomohiro; Shinji Kajiwara; Syusuke Matsuo; Yukihiro Fujimoto; Shu Yamamoto; Takeshi Shichijo; Tetuya Ono
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  31     ISSN:  0916-9636     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-07-17     Completed Date:  2008-08-13     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  615-22     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin II Type 1 Receptor Blockers / administration & dosage*
Benzimidazoles / administration & dosage*
Benzoates / administration & dosage*
Blood Glucose / drug effects
Blood Pressure / drug effects
Coronary Circulation / drug effects*
Echocardiography
Female
Heart Rate / drug effects
Humans
Hypertension / drug therapy*,  physiopathology,  ultrasonography
Hypertrophy, Left Ventricular
Insulin Resistance*
Lipids / blood
Male
Microcirculation / drug effects
Middle Aged
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Benzimidazoles; 0/Benzoates; 0/Blood Glucose; 0/Lipids; U5SYW473RQ/telmisartan
Comments/Corrections
Comment In:
Hypertens Res. 2009 Apr;32(4):316; author reply 317   [PMID:  19282864 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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