The Differential Effects of Angiotensin II Type 1 Receptor Blockers on Microalbuminuria in Relation to Low-Grade Inflammation in Metabolic Hypertensive Patients: (original) (raw)

Journal Article

Yuichiro Yano ,

1

Department of Internal Medicine, Misato Town National Health Insurance Nango Hospital

,

Miyazaki

,

Japan

2

Division of Cardiovascular Medicine, Jichi Medical University School of Medicine

,

Tochigi

,

Japan

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Satoshi Hoshide ,

2

Division of Cardiovascular Medicine, Jichi Medical University School of Medicine

,

Tochigi

,

Japan

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Joji Ishikawa ,

2

Division of Cardiovascular Medicine, Jichi Medical University School of Medicine

,

Tochigi

,

Japan

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Chishio Noguchi ,

3

J-META study group

,

Japan

.

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Daisuke Tukui ,

3

J-META study group

,

Japan

.

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Hidaka Takanori ,

3

J-META study group

,

Japan

.

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Masashi Tada ,

3

J-META study group

,

Japan

.

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Yoshimasa Kanemaru ,

3

J-META study group

,

Japan

.

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Ayako Yano ,

3

J-META study group

,

Japan

.

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Shizukiyo Ishikawa

2

Division of Cardiovascular Medicine, Jichi Medical University School of Medicine

,

Tochigi

,

Japan

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Accepted:

02 December 2006

Cite

Yuichiro Yano, Satoshi Hoshide, Joji Ishikawa, Chishio Noguchi, Daisuke Tukui, Hidaka Takanori, Masashi Tada, Yoshimasa Kanemaru, Ayako Yano, Shizukiyo Ishikawa, Kazuyuki Shimada, Kazuomi Kario, The Differential Effects of Angiotensin II Type 1 Receptor Blockers on Microalbuminuria in Relation to Low-Grade Inflammation in Metabolic Hypertensive Patients: , American Journal of Hypertension, Volume 20, Issue 5, May 2007, Pages 565–572, https://doi.org/10.1016/j.amjhyper.2006.12.008
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Abstract

Background:

A dual angiotensin type 1 receptor blocker (ARB)/peroxisome proliferator-activated receptor-γ (PPARγ) agonist telmisartan may be more useful for microalbuminuria reduction than ARBs with no PPARγ agonistic action. We investigated whether there is a difference between the effects of telmisartan and valsartan with respect to microalbuminuria reduction, and the association with improvement of metabolic features or suppression of the inflammatory state.

Methods:

Fifty-three patients who had metabolic syndrome and had been taking valsartan were recruited. All of these patients were randomly assigned to replace valsartan by telmisartan (telmisartan group; n = 30) or to keep taking valsartan (control group; n = 21). Various parameters were measured at baseline and 12 weeks after randomization.

Results:

There were no significant changes in blood pressure (BP), glucose, and lipid parameters between baseline and 12 weeks after randomization in either group. There was a significant increase in high molecular weight adiponectin in the telmisartan group (4.6 v 5.0 μg/mL, P = .024), whereas there was no significant change in the control group. The reductions of microalbuminuria and high-sensitivity C-reactive protein (hs-CRP) were significant in the telmisartan group (28.1 v 18.9 mg/g · Cr and 0.77 v 0.60 mg/L, respectively, P = .001 and P = .022), whereas there was no significant change in the control group. The reductions of microalbuminuria and hs-CRP were significantly correlated with each other (γ = 0.413, P = .003).

Conclusions:

The dual ARB/PPARγ agonist telmisartan achieved more microalbuminuria reduction than an ARB with no PPARγ agonistic action, possibly through suppression of the inflammatory state in metabolic hypertensive patients. Am J Hypertens 2007;20: 565–572 © 2007 American Journal of Hypertension, Ltd.

© American Journal of Hypertension, Ltd. 2007

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