Original investigation

Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome

Cristiana Vitale^1* , Giuseppe Mercuro^2* , Carlotta Castiglioni^1* , Alessandra Cornoldi^1* , Arianna Tulli^1* , Massimo Fini^1* , Maurizio Volterrani^1* and Giuseppe MC Rosano^1*

¹  Department of Medical Sciences and Rehabilitation, IRCCS San Raffaele, Rome, Italy

²  Department of Cardiology, University of Cagliari, Calgliari, Italy

author email corresponding author email* Contributed equally

Cardiovascular Diabetology 2005, 4:6doi:10.1186/1475-2840-4-6

Published:	15 May 2005

Abstract

Background

Metabolic syndrome is a cluster of common cardiovascular risk factors that includes hypertension and insulin resistance. Hypertension and diabetes mellitus are frequent comorbidities and, like metabolic syndrome, increase the risk of cardiovascular events. Telmisartan, an antihypertensive agent with evidence of partial peroxisome proliferator-activated receptor activity-gamma (PPARγ) activity, may improve insulin sensitivity and lipid profile in patients with metabolic syndrome.

Methods

In a double-blind, parallel-group, randomized study, patients with World Health Organization criteria for metabolic syndrome received once-daily doses of telmisartan (80 mg, n = 20) or losartan (50 mg, n = 20) for 3 months. At baseline and end of treatment, fasting and postprandial plasma glucose, insulin sensitivity, glycosylated haemoglobin (HBA_1c) and 24-hour mean systolic and diastolic blood pressures were determined.

Results

Telmisartan, but not losartan, significantly (p < 0.05) reduced free plasma glucose, free plasma insulin, homeostasis model assessment of insulin resistance and HbA_ic. Following treatment, plasma glucose and insulin were reduced during the oral glucose tolerance test by telmisartan, but not by losartan. Telmisartan also significantly reduced 24-hour mean systolic blood pressure (p < 0.05) and diastolic blood pressure (p < 0.05) compared with losartan.

Conclusion

As well as providing superior 24-hour blood pressure control, telmisartan, unlike losartan, displayed insulin-sensitizing activity, which may be explained by its partial PPARγ activity.