Comparison of the Effects of Telmisartan and Olmesartan on Home Blood Pressure, Glocose, and Lipid Profiles in Patients with Hypertension, Chronic Heart Failure, and Metabolic Syndrome

Sasaki, Tatsuya; Noda, Yoshiki; Yasuoka, Yoshinori; Irino, Hiroaki; Abe, Haruhiko; Adachi, Hidenori; Hattori, Satoshi; Kitada, Hirokazu; Morisawa, Daisuke; Miyatake, Kunio

doi:10.1291/hypres.31.921

Cited by 28 publications

(27 citation statements)

References 46 publications

(54 reference statements)

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“…There are differences between this study and our trial, including different dosage for valsartan (higher doses in our study), longer period of survey (20 mo vs 4 mo), younger study population (49 years vs 65 years), higher values of HOMA-IR (7.7 units vs 3 units), use of Japanese criteria for MS and permission for concomitant medication, but in all, our results confirm the insulin-sensitizing effect of telmisartan. Additionally, we demonstrated that this ARB has a favorable effect on plasma TG and TC in opposition to Ichikawa and other groups [28,29] , but in accordance with others [30][31][32][33][34] . As for valsartan, again in contrast with Ichikawa, but in accordance with larger studies [35,36] , we demonstrated that it also reduces IR, although it has no other effects on lipid profiles.…”

Section: Discussionsupporting

confidence: 92%

Angiotensin-receptor blockers as therapy for mild-to-moderate hypertension-associated non-alcoholic steatohepatitis

Georgescu¹,

Ionescu²,

Niculescu³

et al. 2009

WJG

159

127

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AIM:To evaluate insulin resistance, cytolysis and nonalcoholic steatohepatitis (NASH) score (NAS) using the Kleiner and Brunt criteria in 54 patients with NASH and mild-to-moderate hypertension, treated with telmisartan vs valsartan for 20 mo. METHODS:All patients met the NCEP-ATP Ⅲ criteria for metabolic syndrome. Histology confirmed steatohepatitis, defined as a NAS greater than five up to 3 wk prior inclusion, using the current criteria. Patients with viral hepatitis, chronic alcohol intake, drug abuse or other significant immune or metabolic hepatic pathology were excluded. Subjects were randomly assigned either to the valsartan (V) group (standard dose 80 mg o.d., n = 26), or to the telmisartan (T) group (standard dose 20 mg o.d., n = 28). Treatment had to be taken daily at the same hour with no concomitant medication or alcohol consumption allowed. Neither the patient nor the medical staff was aware of treatment group allocation. Paired liver biopsies obtained at inclusion (visit 1) and end of treatment (EOT) were assessed by a single blinded pathologist, not aware of patient or treatment group. Blood pressure, BMI, ALT, AST, HOMA-IR, plasma triglycerides (TG) and total cholesterol (TC) were evaluated at inclusion and every 4 mo until EOT (visit 6). RESULTS:At EOT we noticed a significant decrease in ALT levels vs inclusion in all patients and this decrease did not differ significantly in group T vs group V. HOMA-IR significantly decreased at EOT vs inclusion in all patients but in group T, the mean HOMA-IR decrease per month was higher than in group V. NAS significantly diminished at EOT in all patients with a higher decrease in group T vs group V. CONCLUSION:Angiotensin receptor blockers seem to be efficient in hypertension-associated NASH. Telmisartan showed a higher efficacy regarding insulin resistance and histology, perhaps because of its specific PPAR-gamma ligand effect.

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Section: Discussionsupporting

confidence: 92%

Angiotensin-receptor blockers as therapy for mild-to-moderate hypertension-associated non-alcoholic steatohepatitis

Georgescu¹,

Ionescu²,

Niculescu³

et al. 2009

WJG

159

127

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“…A direct comparison of olmesartan and telmisartan at standard doses was previously performed in a crossover study after switching from valsartan to assess the antihypertensive effect, metabolic parameters, high molecular weight adiponectin (HMWadiponectin) and highly sensitive C-reactive protein (hs-CRP) [9]. In addition, the effect on the home blood pressure and metabolic parameters was investigated in hypertensive patients with heart failure and metabolic syndrome [10]. However, the efficacy of high-dose therapy with ARBs in type 2 diabetes has not been reported.…”

mentioning

confidence: 99%

Antihypertensive and metabolic effects of high-dose olmesartan and telmisartan in type 2 diabetes patients with hypertension

et al. 2013

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“…A total of 8 non-peptide angiotensin-receptor blockers (ARBs) orally active are used clinically for hypertension and cardiovascular diseases (namely losartan, azilsartan, valsartan, ibesartan, candesartan, telmisartan, eprosartan, omesartan), which are all well-tolerated [129,130] . Telmisartan seems more efficacious in decreasing blood pressure than the other ARBs [131,132] . Many patients with hypertension require combination regimens to achieve a significant decrease in blood pressure.…”

Section: New Targets For Hypertension Treatmentmentioning

confidence: 92%

Renin-angiotensin system in the kidney: What is new?

Ferrão

Lara

Lowe

2014

WJN

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The renin-angiotensin system (RAS) has been known for more than a century as a cascade that regulates body fluid balance and blood pressure. Angiotensin Ⅱ (Ang Ⅱ) has many functions in different tissues; however it is on the kidney that this peptide exerts its main functions. New enzymes, alternative routes for Ang Ⅱ formation or even active Ang Ⅱ-derived peptides have now been described acting on Ang Ⅱ AT1 or AT2 receptors, or in receptors which have recently been cloned, such as Mas and AT4. Another interesting observation was that old members of the RAS, such as angiotensin converting enzyme (ACE), renin and prorenin, well known by its enzymatic activity, can also activate intracellular signaling pathways, acting as an outside-in signal transduction molecule or on the renin/(Pro)renin receptor. Moreover, the endocrine RAS, now is also known to have paracrine, autocrine and intracrine action on different tissues, expressing necessary components for local Ang Ⅱ formation. This in situ formation, especially in the kidney, increases Ang Ⅱ levels to regulate blood pressure and renal functions. These discoveries, such as the ACE2/Ang-(1-7)/Mas axis and its antangonistic effect rather than classical deleterious Ang Ⅱ effects, improves the development of new drugs for treating hypertension and cardiovascular diseases. Key words: Renin-angiotensin system; Angiotensin Ⅱ; Kidney; Hypertension treatment; Receptor Core tip: Activation of the angiotensin converting enzyme (ACE)/ Angiotensin Ⅱ (Ang Ⅱ)/AT1 axis leads to vasoconstriction, anti-diuresis, anti-natriuresis, release of aldosterone and anti-diuretic hormone, which can result in hypertension, renal and cardiovascular diseases. Inhibition of renin and ACE or blocking AT1 receptor is the most used therapies for heart failure and hypertension. Nevertheless, the discovery of local Ang Ⅱ synthesis, new Ang Ⅱ metabolites, receptors and axis of this system, makes possible the development of new drugs and strategies for renal and cardiovascular diseases treatment, such as activation of ACE2/Ang-(1-7)/ Mas axis, which presents opposite effects of AT1 activation by Ang Ⅱ.

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Comparison of the Effects of Telmisartan and Olmesartan on Home Blood Pressure, Glocose, and Lipid Profiles in Patients with Hypertension, Chronic Heart Failure, and Metabolic Syndrome

Abstract: We compared the effects of telmisartan and olmesartan in 20 patients with chronic heart failure and metabolic syndrome. The subjects underwent once-daily 40 mg telmisartan for at least 3 months before switching

Cited by 28 publications

References 46 publications

Angiotensin-receptor blockers as therapy for mild-to-moderate hypertension-associated non-alcoholic steatohepatitis

Angiotensin-receptor blockers as therapy for mild-to-moderate hypertension-associated non-alcoholic steatohepatitis

Antihypertensive and metabolic effects of high-dose olmesartan and telmisartan in type 2 diabetes patients with hypertension

Renin-angiotensin system in the kidney: What is new?

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