Key result
Telmisartan significantly lowered serum triglyceride levels to 114.3 mg/dL compared to 136.5 mg/dL with candesartan (P=0.019) in kidney transplant patients with well-controlled hypertension.
Why the study?
Cardiovascular risk remains elevated after kidney transplantation due in part to abnormal glucose and lipid metabolism, which telmisartan has been uniquely shown to ameliorate among ARBs.
Does telmisartan improve serum triglyceride and adiponectin levels compared to candesartan in kidney transplant patients with well-controlled hypertension?
RCT (n=46)
Open-label
Block-randomization method with varying block size
No
Does telmisartan improve serum triglyceride and adiponectin levels compared to candesartan in kidney transplant patients with well-controlled hypertension?
In kidney transplant patients with well-controlled hypertension, switching to telmisartan significantly reduced serum triglyceride levels and slightly improved eGFR compared to candesartan, though it did not significantly affect adiponectin or glucose metabolism.
Answers are grounded in this paper and cite their sources.
Telmisartan may be favored over candesartan for lipid management in kidney transplant hypertension; extends randomized ARB head-to-head data in this population.
Background The risk of cardiovascular events remains after kidney transplantation (KT). Abnormal glucose metabolism and hyperlipidemia contribute partly to this risk. Among angiotensin II type-1 receptor blockers, telmisartan alone has been shown to ameliorate these effects on glucose and lipid metabolism (GLM). We investigated the effects of telmisartan on GLM in KT patients. Methods This trial had a crossover design. Forty-six KT patients with well-controlled hypertension under angiotensin II type-1 receptor blockers were randomized into telmisartan and candesartan groups. After a 12-week treatment, crossover was initiated, and additional 12-week treatment was administered without a washout period. We examined the laboratory parameters of GLM, blood pressure and graft function before and after each treatment period. Results Forty patients completed the scheduled treatment regimen. Serum levels of triglyceride were significantly lower (114.3 ± 50.8 mg/dL vs 136.5 ± 66.8 mg/dL; P = 0.019), and the estimated glomerular filtration rate was significantly higher (50.4 ± 15.1 mL/min per 1.73 m2 vs 48.5 ± 12.5 mL/min per 1.73 m2; P = 0.038) after telmisartan treatment than after candesartan treatment. There were no significant differences between the 2 treatment groups with regard to the other parameters studied (including serum adiponectin levels and parameters of glucose metabolism). Conclusions These data suggest that telmisartan can improve serum triglyceride levels and graft function for KT patients better than candesartan.
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Miura et al. (2019) conducted an RCT in Kidney transplant with well-controlled hypertension (n=46). Telmisartan vs. Candesartan was evaluated on Serum levels of triglyceride (TG) (p=0.019). Telmisartan significantly lowered serum triglyceride levels to 114.3 mg/dL compared to 136.5 mg/dL with candesartan (P=0.019) in kidney transplant patients with well-controlled hypertension.
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