Therapeutic Research

Abstract

Telmisartan is effective in hypertensive patients with MetS because of its selective PPAR－γ activation mechanism. In such patients, olmesartan also has a strong anti－hypertensive effect. In this study, we compared the effects of these ARBs on blood pressure and metabolic parameters in hypertensive patients with MetS. Methods：Patients were randomized to treatment with telmisartan（TEL；n＝32）or olmesartan（OLM；n＝32）for 12 weeks. At baseline and at 12 weeks they were subjected to blood and urine tests. Extraneous blood pressure and pulse counts were recorded every 4 weeks. The primary endpoint was a change of blood pressure from baseline, and the secondary endpoints were clinical indices（fasting insulin level, fasting blood sugar level, HOMA－R, HbA1c（JDS）, TG, HDL－C, LDL－C）. Results：Systolic blood pressure（SBP）and diastolic blood pressure（DBP）decreased more markedly in TEL than in OLM（ΔSBP：－22.3 mmHg vs. －16.6 mmHg, p＜0.05；ΔDBP：－14.7 mmHg vs. －8.5 mmHg, p＜0.05）. The responder rate in TEL was also significantly higher （87.5％ vs. 53.1％, p＜0.05）. In TEL, the fasting blood sugar level, HOMA－R, TG and LDL－C decreased by 12.3 mg／dL, 0.2, 18.1 mg／dL, and 7.0 mg／dL, respectively, while HDL－C increased by 2.0 mg／dL. In OML, in contrast, those parameters showed little change. Conclusions：In this study, telmisartan demonstrated not only powerful and continuous antihypertensive effects in hypertensive patients with MetS, but also favorable effects on sugar and lipid metabolism.