Key result
Telmisartan significantly improved flow-mediated vasodilation from 7.6% to 9.0% (p<0.01) and reduced arterial stiffness over 8 weeks in patients with essential hypertension.
Why the study?
Does telmisartan improve endothelial function and arterial stiffness in patients with essential hypertension?
Does telmisartan improve endothelial function and arterial stiffness in patients with essential hypertension?
Absolute Event Rate: 9% vs 7.6%
p-value: p=<0.01
Telmisartan 80 mg daily for 8 weeks significantly improves endothelial function and arterial stiffness in patients with essential hypertension, without affecting insulin sensitivity.
May support vascular effects of telmisartan in hypertension; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND AND OBJECTIVES: Several studies have shown that angiotensin II receptor blockers (ARBs) improve endothelial function and arterial stiffness. Telmisartan is a highly selective ARB that activates peroxisome proliferator-activated receptor gamma (PPARgamma). The purpose of this study was to evaluate the effects of telmisartan, such as endothelial function, arterial stiffness, and insulin sensitivity, in patients with essential hypertension. SUBJECTS AND METHODS: Thirty-nine patients with essential hypertension were administered telmisartan (80 mg once daily) using an open-labeled and prospective protocol. The patients were examined before and 8 weeks after treatment to assess changes in flow mediated-vasodilation (FMD), pulse wave velocity (PWV), quantitative insulin-sensitivity check index (QUICKI), homeostasis model assessment (HOMA), and adiponection. RESULTS: The systolic and diastolic blood pressure (BP) decreased from 153+/-15 mmHg and 90+/-13 mmHg to 137+/-16 mmHg and 84+/-10 mmHg after telmisartan treatment, respectively (p<0.01). Telmisartan therapy increased the FMD from 7.6+/-3.5 to 9.0+/-2.8% (p<0.01). The following parameters of arterial stiffness were significantly improved after telmisartan therapy: brachial-ankle pulse wave velocity (baPWV), from 17.2+/-3.1 to 15.9+/-2.6 m/sec; heart-carotid PWV (hcPWV), from 9.7+/-1.8 to 9.0+/-1.9 m/sec; and heart-femoral PWV (hfPWV), from 11.3+/-1.9 to 10.7+/-1.9 m/sec (p<0.01). There were no changes in QUICKI, the HOMA level, and plasma adiponectin (p=NS). CONCLUSION: These results suggest that telmisartan is effective in improving endothelial function and arterial stiffness in patients with essential hypertension.
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Jung et al. (2009) studied essential hypertension (n=39). Telmisartan vs. Baseline was evaluated on flow mediated-vasodilation (FMD) (p=<0.01). Telmisartan significantly improved flow-mediated vasodilation from 7.6% to 9.0% (p<0.01) and reduced arterial stiffness over 8 weeks in patients with essential hypertension.
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