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Effect of the angiotensin receptor blocker irbesartan on metabolic parameters in clinical practice: the DO-IT prospective observational study.

Parhofer KG, Münzel F, Krekler M - Cardiovasc Diabetol (2007)

Bottom Line: We evaluated the effect of irbesartan (150 mg or 300 mg/d) together with or without hydrochlorothiazide (12.5 mg/d) in 3259 German patients.Six months of irbesartan therapy decreased systolic blood pressure by 14% (157.4 +/- 14.7 vs. 135.0 +/- 10.7 mmHg) and diastolic blood pressure by 13% (92.9 +/- 9.2 vs. 80.8 +/- 6.8 mmHg).This was associated with a decrease in body weight (-2.3%), fasting glucose (-9.5%), HbA1c (-4.6%), LDL-cholesterol (-11%), triglycerides (-16%) and gamma-GT (-12%) and an increase in HDL-cholesterol (+5%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Department II - Grosshadern, University Munich, Marchioninistr, 15, 81377 Munich, Germany. klaus.parhofer@med.uni-muenchen.de

ABSTRACT

Aims: A number of intervention studies have shown that therapy with angiotensin receptor blockers, such as irbesartan, can improve metabolic parameters and reduce the incidence of diabetes mellitus. It is unknown whether this observation also holds true in routine clinical settings.

Methods: We evaluated the effect of irbesartan (150 mg or 300 mg/d) together with or without hydrochlorothiazide (12.5 mg/d) in 3259 German patients. A total of 750 primary care physicians evaluated up to 5 subsequent patients with metabolic syndrome (58.9% diabetic), in whom irbesartan therapy was newly initiated (87%) or continued (13%).

Results: Six months of irbesartan therapy decreased systolic blood pressure by 14% (157.4 +/- 14.7 vs. 135.0 +/- 10.7 mmHg) and diastolic blood pressure by 13% (92.9 +/- 9.2 vs. 80.8 +/- 6.8 mmHg). This was associated with a decrease in body weight (-2.3%), fasting glucose (-9.5%), HbA1c (-4.6%), LDL-cholesterol (-11%), triglycerides (-16%) and gamma-GT (-12%) and an increase in HDL-cholesterol (+5%). These changes were somewhat more pronounced in male than in female patients and in obese than in lean patients. Changes in glucose concentration and HbA1c were much more prominent in diabetic patients.

Conclusion: Irbesartan therapy improves metabolic parameters in routine clinical settings. Thus, our study confirms previously published results from large intervention trials and extends the findings to routine clinical practice.

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Related in: MedlinePlus

Effect of irbesartan on metabolic parameters in diabetic and non-diabetic patients with metabolic syndrome. All changes from baseline are significant (p < 0.001). Differences between diabetic and non-diabetic subjects are only significant for HbA1c (p < 0.0001), fasting glucose (p < 0.0001), and HDL-cholesterol (p = 0.05), while differences between diabetic and non-diabetic patients were not significant concerning triglycerides (p = 0.148) and LDL-cholesterol (p = 0.819).
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Figure 1: Effect of irbesartan on metabolic parameters in diabetic and non-diabetic patients with metabolic syndrome. All changes from baseline are significant (p < 0.001). Differences between diabetic and non-diabetic subjects are only significant for HbA1c (p < 0.0001), fasting glucose (p < 0.0001), and HDL-cholesterol (p = 0.05), while differences between diabetic and non-diabetic patients were not significant concerning triglycerides (p = 0.148) and LDL-cholesterol (p = 0.819).

Mentions: All metabolic changes were more pronounced in men than in women, in younger (<62 years) than in older (≥62 years), in more obese (BMI ≥30 kg/m2) than in leaner patients. HbA1c and fasting glucose reduction was significant in diabetic and non-diabetic patients, but was much more pronounced in those with diabetes. All other parameters decreased in diabetic and non-diabetic patients, however, improvement was overall more pronounced in patients with diabetes (Figure 1). Within the group of diabetic patients we did not observe an influence of the underlying anti-diabetic treatment on the metabolic efficacy of irbesartan (data not shown). In a multivariate analysis it was shown that changes in HbA1c and glucose were mostly related to BMI while changes in LDL-cholesterol and triglycerides were related to age. Furthermore, triglycerides, HDL-cholesterol and HbA1c were correlated with sex.


Effect of the angiotensin receptor blocker irbesartan on metabolic parameters in clinical practice: the DO-IT prospective observational study.

Parhofer KG, Münzel F, Krekler M - Cardiovasc Diabetol (2007)

Effect of irbesartan on metabolic parameters in diabetic and non-diabetic patients with metabolic syndrome. All changes from baseline are significant (p < 0.001). Differences between diabetic and non-diabetic subjects are only significant for HbA1c (p < 0.0001), fasting glucose (p < 0.0001), and HDL-cholesterol (p = 0.05), while differences between diabetic and non-diabetic patients were not significant concerning triglycerides (p = 0.148) and LDL-cholesterol (p = 0.819).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2211461&req=5

Figure 1: Effect of irbesartan on metabolic parameters in diabetic and non-diabetic patients with metabolic syndrome. All changes from baseline are significant (p < 0.001). Differences between diabetic and non-diabetic subjects are only significant for HbA1c (p < 0.0001), fasting glucose (p < 0.0001), and HDL-cholesterol (p = 0.05), while differences between diabetic and non-diabetic patients were not significant concerning triglycerides (p = 0.148) and LDL-cholesterol (p = 0.819).
Mentions: All metabolic changes were more pronounced in men than in women, in younger (<62 years) than in older (≥62 years), in more obese (BMI ≥30 kg/m2) than in leaner patients. HbA1c and fasting glucose reduction was significant in diabetic and non-diabetic patients, but was much more pronounced in those with diabetes. All other parameters decreased in diabetic and non-diabetic patients, however, improvement was overall more pronounced in patients with diabetes (Figure 1). Within the group of diabetic patients we did not observe an influence of the underlying anti-diabetic treatment on the metabolic efficacy of irbesartan (data not shown). In a multivariate analysis it was shown that changes in HbA1c and glucose were mostly related to BMI while changes in LDL-cholesterol and triglycerides were related to age. Furthermore, triglycerides, HDL-cholesterol and HbA1c were correlated with sex.

Bottom Line: We evaluated the effect of irbesartan (150 mg or 300 mg/d) together with or without hydrochlorothiazide (12.5 mg/d) in 3259 German patients.Six months of irbesartan therapy decreased systolic blood pressure by 14% (157.4 +/- 14.7 vs. 135.0 +/- 10.7 mmHg) and diastolic blood pressure by 13% (92.9 +/- 9.2 vs. 80.8 +/- 6.8 mmHg).This was associated with a decrease in body weight (-2.3%), fasting glucose (-9.5%), HbA1c (-4.6%), LDL-cholesterol (-11%), triglycerides (-16%) and gamma-GT (-12%) and an increase in HDL-cholesterol (+5%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Department II - Grosshadern, University Munich, Marchioninistr, 15, 81377 Munich, Germany. klaus.parhofer@med.uni-muenchen.de

ABSTRACT

Aims: A number of intervention studies have shown that therapy with angiotensin receptor blockers, such as irbesartan, can improve metabolic parameters and reduce the incidence of diabetes mellitus. It is unknown whether this observation also holds true in routine clinical settings.

Methods: We evaluated the effect of irbesartan (150 mg or 300 mg/d) together with or without hydrochlorothiazide (12.5 mg/d) in 3259 German patients. A total of 750 primary care physicians evaluated up to 5 subsequent patients with metabolic syndrome (58.9% diabetic), in whom irbesartan therapy was newly initiated (87%) or continued (13%).

Results: Six months of irbesartan therapy decreased systolic blood pressure by 14% (157.4 +/- 14.7 vs. 135.0 +/- 10.7 mmHg) and diastolic blood pressure by 13% (92.9 +/- 9.2 vs. 80.8 +/- 6.8 mmHg). This was associated with a decrease in body weight (-2.3%), fasting glucose (-9.5%), HbA1c (-4.6%), LDL-cholesterol (-11%), triglycerides (-16%) and gamma-GT (-12%) and an increase in HDL-cholesterol (+5%). These changes were somewhat more pronounced in male than in female patients and in obese than in lean patients. Changes in glucose concentration and HbA1c were much more prominent in diabetic patients.

Conclusion: Irbesartan therapy improves metabolic parameters in routine clinical settings. Thus, our study confirms previously published results from large intervention trials and extends the findings to routine clinical practice.

Show MeSH
Related in: MedlinePlus