Effects of telmisartan compared with eprosartan on blood pressure control, glucose metabolism and lipid profile in hypertensive, type 2 diabetic patients: a randomized, double-blind, placebo-controlled 12-month study

Hypertens Res. 2004 Jul;27(7):457-64. doi: 10.1291/hypres.27.457.

Abstract

We evaluated the antihypertensive activity, glucose homeostasis and plasma lipid profile in patients with mild hypertension and type 2 diabetes mellitus treated by diet and exercise, and not in receipt of oral hyperglycemics, following 12-month treatment with either telmisartan or eprosartan. In this double-blind, placebo-controlled trial, 119 patients with mild essential hypertension (diastolic blood pressure [DBP] 91-104 mmHg) and type 2 diabetes were divided into three groups and randomized to receive once-daily telmisartan 40 mg, eprosartan 600 mg, or placebo for 12 months. At enrollment, patients were advised on diet (1,400-1,600 kcal/day) and exercise (physical aerobics on a bicycle for at least 30 min on 4 days each week). Compared with baseline, a significant reduction (p<0.01) in seated trough systolic blood pressure (SBP) was detected after 12-month treatment with either telmisartan or eprosartan. Seated trough DBP was also reduced by telmisartan (p<0.01) and eprosartan (p<0.05); the antihypertensive effect of telmisartan was significantly superior (p<0.05). No change in body mass index or glucose metabolism was observed with either active treatment, or with placebo. Telmisartan, but not eprosartan, significantly improved plasma total cholesterol (p<0.01), low-density lipoprotein cholesterol (p<0.01) and triglycerides (p<0.05) compared with eprosartan. In conclusion, 12-month telmisartan treatment produced a significantly greater reduction in DBP than eprosartan and significantly improved plasma lipids. The improvement could be due to varying pharmacokinetic/pharmacodynamic properties of telmisartan compared with eprosartan, even if it is not clear about the relationship between angiotensin-II receptor blockade and 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibition.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acrylates / adverse effects
  • Acrylates / therapeutic use*
  • Angiotensin II Type 1 Receptor Blockers / adverse effects
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Benzimidazoles / adverse effects
  • Benzimidazoles / therapeutic use*
  • Benzoates / adverse effects
  • Benzoates / therapeutic use*
  • Blood Pressure / drug effects*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Angiopathies / drug therapy*
  • Diabetic Angiopathies / etiology
  • Diabetic Angiopathies / physiopathology
  • Double-Blind Method
  • Female
  • Glucose / metabolism*
  • Homeostasis
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / etiology
  • Hypertension / physiopathology
  • Imidazoles / adverse effects
  • Imidazoles / therapeutic use*
  • Lipids / blood*
  • Male
  • Middle Aged
  • Telmisartan
  • Thiophenes / adverse effects
  • Thiophenes / therapeutic use*

Substances

  • Acrylates
  • Angiotensin II Type 1 Receptor Blockers
  • Benzimidazoles
  • Benzoates
  • Imidazoles
  • Lipids
  • Thiophenes
  • eprosartan
  • Glucose
  • Telmisartan