Some classes of antihypertensive agents, notably angiotensin II receptor blockers (ARBs), are known to reduce the incidence of new-onset DM. Compared with other ARBs, telmisartan, which has a partial agonist effect on the peroxisome proliferator-activated receptor-γ (PPAR-γ) [1,2], is expected to have particularly useful effects. However, few studies have analyzed intra-class ARB differences with respect to their antidiabetic effects or metabolic effects.Adiponectin is one of the adipocyte-derived hormones that has profound anti-inflammatory and antiatherogenic properties. Adiponectin has also been postulated to play an important role in the modulation of glucose and lipid metabolism. A reduced adiponectin level is thought to play a role in the pathogenesis of cardiovascular diseases.The effect that ARBs and other antihypertensive agents have on serum adiponectin levels and glucose intolerance was investigated by doing a cross-sectional analysis.The study population was recruited from consecutive hypertensive outpatients treated with antihypertensive drugs at our university hospital and Saiki hospital (n=281; 135 males; average age, 66.9 years; range, 40-80 years). Patients were included in the study if their antihypertensive or lipid lowering drugs had not changed in the past year.Patients who had been previously diagnosed as having DM or impaired glucose tolerance (IGT), and those who had clinically evident atherosclerotic diseases, such as coronary artery, peripheral artery, or cerebrovascular disease, were excluded.In all patients, fasting blood samples were obtained for routine evaluation of hematology and biochemical parameters, including the insulin concentration. Serum adiponectin levels were measured using ELISA. A 75 g oral glucose tolerance test (75 gOGTT) was also done. Using the WHO criteria, patients were classified into three groups: the normal glucose tolerance (NGT) group; the IGT group; and the DM group. Data are expressed as means ± SD.Sixty-nine patients (24.6%) with DM and 109 patients (38.8%) with IGT were newly diagnosed based on the 75 g OGTT results. The antihypertensive agents that were used by the subjects, the incidence of DM, and the association between each agent that was used and the serum adiponectin level are shown in Table 1. The percentage of patients who had DM (17.2%) was significantly lower among patients taking ARBs than among patients not taking ARBs (29.2%, p=0.023). There were no significant differences in the prevalence of DM between patients taking and not taking calcium antagonists, ACE inhibitors, β-blockers, or α-blockers. On multiple linear regression analysis, only the use of telmisartan was found to have a significant positive correlation with the serum adiponectin level when adjusted by age, gender, waist circumference, and statin use (coefficient 3.41, 95% confidence interval 1.40-5.41, p= 0.001); other ARBs and other classes of antihypertensive agents were not found to have a significant positive correlation with the serum adiponectin level (Table).