| Telmisartan, an angiotensin II type 1 receptor blocker, improves coronary microcirculation and insulin resistance among essential hypertensive patients without left ventricular hypertrophy. | |
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MedLine Citation:
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PMID: 18633172 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Toshihide Hinoi; Yasuyuki Tomohiro; Shinji Kajiwara; Syusuke Matsuo; Yukihiro Fujimoto; Shu Yamamoto; Takeshi Shichijo; Tetuya Ono |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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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:
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Created Date: 2008-07-17 Completed Date: 2008-08-13 Revised Date: 2009-09-21 |
Medline Journal Info:
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Nlm Unique ID: 9307690 Medline TA: Hypertens Res Country: Japan |
Other Details:
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Languages: eng Pagination: 615-22 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Kure Kyosai Hospital, Kure, Japan. t-hinoi@kure-kyosai.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Angiotensin II Type 1 Receptor Blockers; 0/Benzimidazoles; 0/Benzoates; 0/Blood Glucose; 0/Lipids; 144701-48-4/telmisartan |
| Comments/Corrections | |
Comment In:
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Hypertens Res. 2009 Apr;32(4):316; author reply 317
[PMID:
19282864
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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