Antihypertensive and metabolic effects of high-dose olmesartan and telmisartan in type 2 diabetes patients with hypertension

Endocr J. 2013;60(5):563-70. doi: 10.1507/endocrj.ej12-0326. Epub 2013 Jan 10.

Abstract

We performed a crossover study in hypertensive patients with type 2 diabetes to compare olmesartan (40 mg/day) with telmisartan (80 mg/day) in terms of their antihypertensive and metabolic effects. The subjects were 36 patients (20 men and 16 women) with type 2 diabetes who did not achieve a blood pressure <130/80 mmHg following treatment with olmesartan at 40 mg/day or telmisartan at 80 mg/day for 8 weeks or more. The primary endpoint was the blood pressure reduction rate, while the secondary endpoints were BMI, parameters of glucose metabolism, HMW-adiponectin, hs-CRP and lipids metabolism. All parameters were measured in Weeks 0, 12, and 24. Treatments were switched in Week 0, and Week 12 and the following results were obtained. There were 1) no significant differences in baseline characteristics; 2) no significant difference of the blood pressure reduction rate; 3) significant reductions of HbA1c (NGSP), FPG and HOMA-IR in olmesartan group; 4) a significant increase of HDL-C in olmesartan group; 5) a decrease of hs-CRP and a increase of HMW-adiponectin in olmesartan group; and 6) a positive correlation between the percent changes of HOMA-IR and hs-CRP in olmesartan group. In conclusion, there was no difference of the blood pressure reduction achieved at the highest dose in olmesartan group and telmisartan group. But improvement of glycemic control and insulin resistance was only observed in olmesartan group. Because there was a correlation between the percent changes of HOMA-IR and hs-CRP, these effects of olmesartan might be mediated by an anti-inflammatory action.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiotensin II Type 1 Receptor Blockers / administration & dosage
  • Angiotensin II Type 1 Receptor Blockers / adverse effects
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Benzimidazoles / administration & dosage
  • Benzimidazoles / adverse effects
  • Benzimidazoles / therapeutic use*
  • Benzoates / administration & dosage
  • Benzoates / adverse effects
  • Benzoates / therapeutic use*
  • C-Reactive Protein / analysis
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / complications
  • Diabetic Angiopathies / drug therapy*
  • Diabetic Angiopathies / immunology
  • Drug Resistance
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertension / blood
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / immunology
  • Hypoglycemic Agents / therapeutic use
  • Imidazoles / administration & dosage
  • Imidazoles / adverse effects
  • Imidazoles / therapeutic use*
  • Insulin Resistance
  • Male
  • Middle Aged
  • Telmisartan
  • Tetrazoles / administration & dosage
  • Tetrazoles / adverse effects
  • Tetrazoles / therapeutic use*

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antihypertensive Agents
  • Benzimidazoles
  • Benzoates
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypoglycemic Agents
  • Imidazoles
  • Tetrazoles
  • olmesartan
  • C-Reactive Protein
  • Telmisartan