Effect of telmisartan on metabolic syndrome components and cardiovascular protection: A prospective observational study.

Background Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including central obesity, hypertension, dyslipidaemia, and insulin resistance, which substantially increase the risk of diabetes mellitus and cardiovascular disease. .To evaluate the effect of telmisartan on the components of metabolic syndrome and its role in cardiovascular protection. Methods This prospective observational study included 100 patients with MetS, treated with telmisartan (40–80 mg daily) for 24 weeks. Blood pressure, fasting glucose, fasting insulin, HOMA-IR, lipid profile, waist circumference, and BMI were measured at baseline, 12 weeks, and 24 weeks. Cardiovascular protection was assessed by pulse wave velocity (PWV) and flow-mediated dilation (FMD). Data were analysed using paired t-tests, with p<0.05 considered significant. Results Telmisartan significantly reduced systolic (152.8 ± 12.6 to 132.6 ± 8.7 mmHg; p<0.001) and diastolic blood pressure (94.6 ± 8.1 to 82.3 ± 6.1 mmHg; p<0.001). Fasting glucose (118.6 ± 16.4 to 104.8 ± 12.7 mg/dL; p<0.01), fasting insulin (16.2 ± 4.8 to 11.7 ± 3.9 µU/mL; p<0.01), and HOMA-IR (4.8 ± 1.5 to 3.1 ± 1.1; p<0.01) improved significantly. Lipid profile showed reduced triglycerides and LDL-C, and increased HDL-C. Waist circumference and BMI decreased modestly (p<0.05). Cardiovascular protection markers improved, with reduced PWV (10.2 ± 1.8 to 8.7 ± 1.5 m/s; p<0.01) and increased FMD (6.4 ± 1.3% to 9.1 ± 1.6%; p<0.01). Telmisartan was well tolerated with only mild, transient adverse events. Conclusion Telmisartan effectively improves multiple components of metabolic syndrome while enhancing vascular function, thereby offering both metabolic and cardiovascular protection. Its dual ARB and PPAR-γ activity make it a valuable therapeutic option in high-risk MetS patients. Recommendations Telmisartan should be preferred in metabolic syndrome for simultaneous blood pressure control, improved insulin sensitivity, and enhanced cardiovascular protection.