Improvement of endothelial function in patients with hypertension and type 2 diabetes after treatment with telmisartan.

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Wago T, Yoshimoto T, Akaza I, Tsuchiya K, Izumiyama H, Doi M, Hirata Y

Improvement of endothelial function in patients with hypertension and type 2 diabetes after treatment with telmisartan.

Hypertens Res. 2010 Aug;33(8):796-801. doi: 10.1038/hr.2010.107. Epub 2010 Jun 17.

PubMed ID

20555330 [ View in PubMed

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Abstract

Telmisartan, a selective antagonist for angiotensin type1 receptor and a partial agonist for peroxisome proliferator-activated receptor-gamma, decreases blood pressure and has been shown to improve glucose and lipid metabolism, suggesting potential cardiovascular protective effects. In this study, we investigated whether long-term treatment with telmisartan improved endothelial function in 35 hypertensive patients with type 2 diabetes mellitus (T2DM). Office and home early morning blood pressure levels and flow-mediated vasodilation (FMD) were evaluated before and after 12 months of treatment with telmisartan. Blood samples were also obtained for measurement of several biochemical parameters and of adiponectin (AN) and highly sensitive C-reactive protein (hs-CRP) before and after treatment. After 12 months of treatment, office and morning blood pressure levels had significantly decreased, and levels of plasma glucose, glycosylated hemoglobin, total cholesterol, triglyceride and low-density lipoprotein cholesterol had also significantly decreased. Plasma AN and high-density lipoprotein cholesterol levels increased, but hs-CRP levels decreased. Furthermore, FMD significantly increased; changes in percent FMD showed a significant negative correlation with changes in systolic and diastolic blood pressure and a significant positive correlation with changes in AN. Stepwise multivariate regression analysis revealed that changes in plasma AN and office systolic blood pressure were both independent determinants for endothelial function after telmisartan treatment. In conclusion, this study shows that long-term treatment with telmisartan improves not only blood pressure and glucose and lipid metabolism but also endothelial function in hypertensive patients with T2DM, possibly by increased circulating AN and decreased blood pressure.

DrugBank Data that Cites this Article

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Telmisartan	Approved Investigational	Glucose	decreased	Telmisartan decreases the level of Glucose in the blood
Telmisartan	Approved Investigational	Total cholesterol	decreased	Telmisartan decreases the level of Total cholesterol in the blood
Telmisartan	Approved Investigational	LDL cholesterol	decreased	Telmisartan decreases the level of LDL cholesterol in the blood
Telmisartan	Approved Investigational	HDL cholesterol	increased	Telmisartan increases the level of HDL cholesterol in the blood
Telmisartan	Approved Investigational	Triglycerides	decreased	Telmisartan decreases the level of Triglycerides in the blood

Pharmaco-proteomics

Drug	Drug Groups	Gene	Gene ID	Change	Interaction	Chromosome
Telmisartan	Approved Investigational	CRP	1401	decreased	telmisartan results in decreased expression of CRP protein	1q23.2
Telmisartan	Approved Investigational	ADIPOQ	9370	increased	telmisartan results in increased expression of ADIPOQ protein	3q27.3