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Open-label, Randomized Crossover Study Between Telmisartan and Valsartan on Improving Insulin Resistance and Adipocytokines in Nondiabetic Patients with Mild Hypertension.

Ohbayashi H, Minatoguchi S, Aoyama T, Fujiwara H - J Rural Med (2010)

Bottom Line: Serum adiponectin did not increase in either treatment group.Serum hsCRP levels also significantly decreased in the high hsCRP subjects (>/=0.1) of both treatment groups (p=0.044 and p=0.015, respectively).Telmisartan significantly improved insulin resistance, possibly through the effect on PPAR-gamma, while both telmisartan and valsartan significantly decreased serum leptin levels in female groups and hsCRP in both genders, suggesting no significantly different effects on adipocytokines by either drug in nondiabetic patients with mild hypertension.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, JA Gifu Tohno-Kousei Hospital, Japan ; Second Department of Internal Medicine, Gifu University School of Medicine, Japan.

ABSTRACT

Objective: The comparative effect of telmisartan and valsartan upon insulin resistance and adipocytokines in nondiabetic patients with mild hypertension is unclear.

Methods: Fifty nondiabetic patients with untreated mild hypertension were randomly assigned to telmisartan (40 mg/day) and valsartan (80 mg/day) groups and were switched in a crossover manner at 3-month intervals. Serum leptin, adiponectin, hsCRP and the HOMA-R were measured before and at 3 months during each treatment period.

Results: The HOMA-R significantly improved over the 3 months in the high insulin resistance group (HOMA-R>/=2.5) during the telmisartan treatment period (p=0.042), but not during the valsartan period. Both telmisartan and valsartan significantly decreased serum leptin levels in each female group during each treatment period (p<0.001 and p<0.001, respectively), but not in the male groups. Serum adiponectin did not increase in either treatment group. Serum hsCRP levels also significantly decreased in the high hsCRP subjects (>/=0.1) of both treatment groups (p=0.044 and p=0.015, respectively).

Conclusions: Telmisartan significantly improved insulin resistance, possibly through the effect on PPAR-gamma, while both telmisartan and valsartan significantly decreased serum leptin levels in female groups and hsCRP in both genders, suggesting no significantly different effects on adipocytokines by either drug in nondiabetic patients with mild hypertension.

No MeSH data available.


Related in: MedlinePlus

(A) Study protocol and (B) Flow chart of study participants.
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fig_001: (A) Study protocol and (B) Flow chart of study participants.

Mentions: The subjects enrolled in the study were 50 nondiabetic outpatients with untreated mildhypertension. According to the guideline of the Japanese Society of Hypertension, valuesfor systolic blood pressure of 140–159 mmHg or diastolic blood pressure of 90–99 mmHg arediagnosed as mild hypertension. After obtaining full informed consent from eachparticipant, the participants were randomly divided into two groups, the initialtelmisartan group and the initial valsartan group. The study subjects in the initialtelmisartan group were treated with 40 mg/day of telmisartan for the first 3 months andwere switched to a therapeutically equivalent dose of valsartan (80 mg/day) for the next 3months. In contrast, those in the initial valsartan group were treated with 80 mg/day ofvalsartan for the first 3 months and then 40 mg/day of telmisartan for the next 3 months.Other kinds of medications used before the study, were allowed as concurrently taken drugsduring the study, with the doses of these drugs being kept constant throughout the studyperiods. This study was carried out in accordance with the principles embodied in theHelsinki Declaration of 1995 (as revised in Edinburgh 2000).


Open-label, Randomized Crossover Study Between Telmisartan and Valsartan on Improving Insulin Resistance and Adipocytokines in Nondiabetic Patients with Mild Hypertension.

Ohbayashi H, Minatoguchi S, Aoyama T, Fujiwara H - J Rural Med (2010)

(A) Study protocol and (B) Flow chart of study participants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4309358&req=5

fig_001: (A) Study protocol and (B) Flow chart of study participants.
Mentions: The subjects enrolled in the study were 50 nondiabetic outpatients with untreated mildhypertension. According to the guideline of the Japanese Society of Hypertension, valuesfor systolic blood pressure of 140–159 mmHg or diastolic blood pressure of 90–99 mmHg arediagnosed as mild hypertension. After obtaining full informed consent from eachparticipant, the participants were randomly divided into two groups, the initialtelmisartan group and the initial valsartan group. The study subjects in the initialtelmisartan group were treated with 40 mg/day of telmisartan for the first 3 months andwere switched to a therapeutically equivalent dose of valsartan (80 mg/day) for the next 3months. In contrast, those in the initial valsartan group were treated with 80 mg/day ofvalsartan for the first 3 months and then 40 mg/day of telmisartan for the next 3 months.Other kinds of medications used before the study, were allowed as concurrently taken drugsduring the study, with the doses of these drugs being kept constant throughout the studyperiods. This study was carried out in accordance with the principles embodied in theHelsinki Declaration of 1995 (as revised in Edinburgh 2000).

Bottom Line: Serum adiponectin did not increase in either treatment group.Serum hsCRP levels also significantly decreased in the high hsCRP subjects (>/=0.1) of both treatment groups (p=0.044 and p=0.015, respectively).Telmisartan significantly improved insulin resistance, possibly through the effect on PPAR-gamma, while both telmisartan and valsartan significantly decreased serum leptin levels in female groups and hsCRP in both genders, suggesting no significantly different effects on adipocytokines by either drug in nondiabetic patients with mild hypertension.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, JA Gifu Tohno-Kousei Hospital, Japan ; Second Department of Internal Medicine, Gifu University School of Medicine, Japan.

ABSTRACT

Objective: The comparative effect of telmisartan and valsartan upon insulin resistance and adipocytokines in nondiabetic patients with mild hypertension is unclear.

Methods: Fifty nondiabetic patients with untreated mild hypertension were randomly assigned to telmisartan (40 mg/day) and valsartan (80 mg/day) groups and were switched in a crossover manner at 3-month intervals. Serum leptin, adiponectin, hsCRP and the HOMA-R were measured before and at 3 months during each treatment period.

Results: The HOMA-R significantly improved over the 3 months in the high insulin resistance group (HOMA-R>/=2.5) during the telmisartan treatment period (p=0.042), but not during the valsartan period. Both telmisartan and valsartan significantly decreased serum leptin levels in each female group during each treatment period (p<0.001 and p<0.001, respectively), but not in the male groups. Serum adiponectin did not increase in either treatment group. Serum hsCRP levels also significantly decreased in the high hsCRP subjects (>/=0.1) of both treatment groups (p=0.044 and p=0.015, respectively).

Conclusions: Telmisartan significantly improved insulin resistance, possibly through the effect on PPAR-gamma, while both telmisartan and valsartan significantly decreased serum leptin levels in female groups and hsCRP in both genders, suggesting no significantly different effects on adipocytokines by either drug in nondiabetic patients with mild hypertension.

No MeSH data available.


Related in: MedlinePlus