Key result
Telmisartan significantly increased adiponectin levels by 0.68 microg/ml (P<0.01) and reduced systolic blood pressure by 13.5 mm Hg, showing greater effects than ramipril.
Why the study?
Does telmisartan compared to ramipril improve adiponectin levels and blood pressure in patients with type 2 diabetes?
RCT (n=87)
Does telmisartan compared to ramipril improve adiponectin levels and blood pressure in patients with type 2 diabetes?
Absolute Event Rate: 0.68% vs 0.17%
p-value: p=<0.01
Telmisartan, but not ramipril, significantly increases adiponectin levels and provides greater blood pressure reduction in patients with type 2 diabetes over 9 weeks.
Telmisartan may be preferred over ramipril for BP control plus adiponectin rise in T2D; extends RCT evidence on ARB metabolic effects.
BACKGROUND: Adiponectin is secreted by adipose tissue and may play a role in cardiovascular disease. We examined adiponectin levels in patients with type 2 diabetes who participated in the Telmisartan vs. Ramipril in Renal Endothelial Dysfunction (TRENDY) study. METHODS: A total of 87 patients were assessed at baseline and following 9 weeks treatment with the angiotensin-receptor blocker telmisartan (final dose, 80 mg; n = 45) or the angiotensin-converting enzyme inhibitor ramipril (final dose, 10 mg; n = 42). Adiponectin levels were measured in plasma by radioimmunoassay. RESULTS: Adiponectin levels were inversely correlated with systolic (SBP; r = -0.240, P < 0.05) and diastolic (DBP; r = -0.227, P < 0.05) blood pressure at baseline and following treatment with telmisartan or ramipril (SBP: r = -0.228, P < 0.05; DBP: r = -0.286, P < 0.05). Changes in adiponectin levels were related to changes in SBP (r = -0.357, P < 0.01) and DBP (r = -0.286, P < 0.01). There was a significant increase in adiponectin levels in the telmisartan (0.68 (95% confidence interval (CI), 0.27 to 1.10) microg/ml, P < 0.01) but not in the ramipril group (0.17 (95% CI, -0.56 to 0.90) microg/ml, P = 0.67). Blood pressure reduction in the telmisartan group (DeltaSBP: -13.5 (95% CI, -17.0 to -10.0) mm Hg; DeltaDBP: -7.6 (95% CI, -9.8 to -5.3) mm Hg, each P < 0.001) was significantly (P < or = 0.01 for SBP and P < 0.01 for DBP) greater than in the ramipril group (DeltaSBP: -6.1 (95% CI, -6.2 to -2.0) mm Hg; DeltaDBP: -2.7 (95% CI, -5.0 to -0.5) mm Hg; P < 0.01 and P < 0.05, respectively). CONCLUSION: Adiponectin is correlated with blood pressure in patients with type 2 diabetes. Whether increased adiponectin contributes to the blood pressure-lowering effect of telmisartan needs further study.
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Delles et al. (2008) conducted an RCT in Type 2 diabetes (n=87). Telmisartan vs. Ramipril was evaluated on Change in adiponectin levels (microg/ml) (p=<0.01). Telmisartan significantly increased adiponectin levels by 0.68 microg/ml (P<0.01) and reduced systolic blood pressure by 13.5 mm Hg, showing greater effects than ramipril.