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

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 v...

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Published in:	American journal of hypertension Vol. 20; no. 5; pp. 565 - 572
Main Authors:	Yano, Yuichiro, Hoshide, Satoshi, Ishikawa, Joji, Noguchi, Chishio, Tukui, Daisuke, Takanori, Hidaka, Tada, Masashi, Kanemaru, Yoshimasa, Yano, Ayako, Ishikawa, Shizukiyo, Shimada, Kazuyuki, Kario, Kazuomi
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-05-2007 Oxford University Press Elsevier Science
Subjects:	Aged Albuminuria - drug therapy Albuminuria - etiology Angiotensin II Type 1 Receptor Blockers - therapeutic use Antihypertensive agents Arterial hypertension. Arterial hypotension Benzimidazoles - therapeutic use Benzoates - therapeutic use Biological and medical sciences Blood and lymphatic vessels Blood Pressure C-Reactive Protein - analysis Cardiology. Vascular system Cardiovascular system Clinical manifestations. Epidemiology. Investigative techniques. Etiology Female HMW adiponectin Humans Hypertension - complications inflammation Inflammation - drug therapy Inflammation - etiology Male Medical sciences Metabolic Syndrome - complications microalbuminuria Pharmacology. Drug treatments PPAR gamma - agonists PPARγ Telmisartan Treatment Outcome microalbuminuria inflammation PPARγ Telmisartan HMW adiponectin Human Hypertension Urinary system disease PPARy Peptide hormone Albumin Cardiovascular disease Inflammation AT1 angiotensin receptor Octapeptide Benzimidazole derivatives Antihypertensive agent Angiotensin antagonist Angiotensin II Microalbuminuria Proteinuria
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Summary:	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. 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. 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). 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.
Bibliography:	href:20_5_565.pdf ark:/67375/HXZ-K0WX4SDT-G istex:F4F7C16AEFB1C808F427B9FAC66167098D45EF65 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0895-7061 1879-1905 1941-7225
DOI:	10.1016/j.amjhyper.2006.12.008