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Comparison of the effects of three angiotensin II receptor type 1 blockers on metabolic parameters in hypertensive patients with type 2 diabetes mellitus.
Eur J Intern Med. 2010 Jun; 21(3):236-9.EJ

Abstract

OBJECTIVE

In a previous study involving 18 hypertensive patients with type 2 diabetes mellitus, we found that replacement of valsartan and candesartan by telmisartan significantly improved insulin sensitivity and significantly increased serum adiponectin levels in the patients. We investigated the effects of 3 angiotensin II type 1 receptor blockers (ARBs)-telmisartan, candesartan, and valsartan-on metabolic parameters in hypertensive patients with type 2 diabetes.

METHODS

A total of 308 hypertensive patients with diabetes were enrolled in our multicentre, randomized, open-label study. The patients received 40 mg telmisartan, 8 mg candesartan, or 80 mg valsartan for 3 months, and the data of 227 patients (telmisartan: n=74, candesartan: n=79, and valsartan: n=74) were analysed.

RESULTS

The systolic and diastolic blood pressures significantly decreased in all the groups at the end of the study; the decrease was comparable among the 3 groups. The changes in fasting plasma glucose, fasting insulin, glycated haemoglobin (HbA1c), total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, adiponectin, free fatty acids, high-sensitivity C-reactive protein (hs-CRP), and plasminogen activator inhibitor-1 (PAI-1) were comparable between the 3 groups. Telmisartan and candesartan administration tended to lower urinary albumin excretion.

CONCLUSIONS

Low dose telmisartan had a neutral effect on metabolic dysfunction in hypertensive patients with type 2 diabetes; the effect produced by 40 mg telmisartan was comparable with that of 8 mg candesartan and 80 mg valsartan. Failure to detect metabolic differences among the various ARB treatments could have been due to the low statistical power of the study design.

Authors+Show Affiliations

Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Japan. n-ozaki@med.nagoya-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20493430

Citation

Ozaki, Nobuaki, et al. "Comparison of the Effects of Three Angiotensin II Receptor Type 1 Blockers On Metabolic Parameters in Hypertensive Patients With Type 2 Diabetes Mellitus." European Journal of Internal Medicine, vol. 21, no. 3, 2010, pp. 236-9.
Ozaki N, Nomura Y, Sobajima H, et al. Comparison of the effects of three angiotensin II receptor type 1 blockers on metabolic parameters in hypertensive patients with type 2 diabetes mellitus. Eur J Intern Med. 2010;21(3):236-9.
Ozaki, N., Nomura, Y., Sobajima, H., Kondo, K., & Oiso, Y. (2010). Comparison of the effects of three angiotensin II receptor type 1 blockers on metabolic parameters in hypertensive patients with type 2 diabetes mellitus. European Journal of Internal Medicine, 21(3), 236-9. https://doi.org/10.1016/j.ejim.2010.01.014
Ozaki N, et al. Comparison of the Effects of Three Angiotensin II Receptor Type 1 Blockers On Metabolic Parameters in Hypertensive Patients With Type 2 Diabetes Mellitus. Eur J Intern Med. 2010;21(3):236-9. PubMed PMID: 20493430.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the effects of three angiotensin II receptor type 1 blockers on metabolic parameters in hypertensive patients with type 2 diabetes mellitus. AU - Ozaki,Nobuaki, AU - Nomura,Yoshio, AU - Sobajima,Hiroshi, AU - Kondo,Kunikazu, AU - Oiso,Yutaka, Y1 - 2010/02/18/ PY - 2009/07/18/received PY - 2010/01/21/revised PY - 2010/01/22/accepted PY - 2010/5/25/entrez PY - 2010/5/25/pubmed PY - 2010/8/24/medline SP - 236 EP - 9 JF - European journal of internal medicine JO - Eur J Intern Med VL - 21 IS - 3 N2 - OBJECTIVE: In a previous study involving 18 hypertensive patients with type 2 diabetes mellitus, we found that replacement of valsartan and candesartan by telmisartan significantly improved insulin sensitivity and significantly increased serum adiponectin levels in the patients. We investigated the effects of 3 angiotensin II type 1 receptor blockers (ARBs)-telmisartan, candesartan, and valsartan-on metabolic parameters in hypertensive patients with type 2 diabetes. METHODS: A total of 308 hypertensive patients with diabetes were enrolled in our multicentre, randomized, open-label study. The patients received 40 mg telmisartan, 8 mg candesartan, or 80 mg valsartan for 3 months, and the data of 227 patients (telmisartan: n=74, candesartan: n=79, and valsartan: n=74) were analysed. RESULTS: The systolic and diastolic blood pressures significantly decreased in all the groups at the end of the study; the decrease was comparable among the 3 groups. The changes in fasting plasma glucose, fasting insulin, glycated haemoglobin (HbA1c), total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, adiponectin, free fatty acids, high-sensitivity C-reactive protein (hs-CRP), and plasminogen activator inhibitor-1 (PAI-1) were comparable between the 3 groups. Telmisartan and candesartan administration tended to lower urinary albumin excretion. CONCLUSIONS: Low dose telmisartan had a neutral effect on metabolic dysfunction in hypertensive patients with type 2 diabetes; the effect produced by 40 mg telmisartan was comparable with that of 8 mg candesartan and 80 mg valsartan. Failure to detect metabolic differences among the various ARB treatments could have been due to the low statistical power of the study design. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/20493430/Comparison_of_the_effects_of_three_angiotensin_II_receptor_type_1_blockers_on_metabolic_parameters_in_hypertensive_patients_with_type_2_diabetes_mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(10)00017-8 DB - PRIME DP - Unbound Medicine ER -