Key result
Telmisartan provides superior vasoprotection over losartan in hypertensive CKD through PPAR-gamma activation.
Why the study?
Telmisartan, a partial PPAR-γ agonist, may provide stronger vasoprotection than losartan in hypertensive CKD rats, but this effect requires investigation.
Should not yet change ARB choice in hypertensive CKD; leaves open whether PPAR-γ agonism improves human vascular outcomes.
BACKGROUND/AIMS: Telmisartan and losartan, angiotensin II type 1 (AT1) receptor antagonists, are used to manage hypertension. We previously reported that telmisartan, a partial agonist of peroxisome proliferator-activated receptor-γ (PPAR-γ), exhibited stronger vasoprotection than the same dose of losartan in normotensive chronic kidney disease (CKD) rats. We investigated whether telmisartan could inhibit vascular dysfunction in hypertensive CKD rats, via both AT1 receptor blockade and PPAR-γ activation, more effectively than losartan, which decreased blood pressure to a similar extent as telmisartan. METHODS: Two or three branches of the left renal artery were ligated and the right kidney was removed to make hypertensive CKD rats. Telmisartan (5 mg/kg), losartan (10 mg/kg) or telmisartan plus the PPAR-γ antagonist GW9662 was administered. RESULTS: Blood pressure was increased in CKD rats. Telmisartan and losartan decreased blood pressure to the same levels. Impaired endothelium-dependent vasodilation, hyperplasia and decreased phospho-eNOS (Ser(1177)) expression in CKD rat aortas were improved by telmisartan. The aortic infiltration by macrophages and expression of osteopontin were enhanced in CKD rats and suppressed by telmisartan. GW9662 partly canceled the normalization of vascular dysfunction. While losartan attenuated vascular changes, the extent of this attenuation was greater in the telmisartan-treated group. CONCLUSION: Telmisartan exhibited vasoprotection via PPAR-γ agonistic properties in hypertensive CKD rats.
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Toba et al. (2013) studied Hypertensive chronic kidney disease (CKD). Telmisartan vs. Losartan (10 mg/kg) or telmisartan plus GW9662 was evaluated on Vascular dysfunction, including endothelium-dependent vasodilation and hyperplasia. Telmisartan exhibited stronger vasoprotection than losartan in hypertensive chronic kidney disease rats through PPAR-γ agonistic properties, improving impaired endothelium-dependent vasodilation and suppressing hyperplasia.
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