Metabolic effect of combined telmisartan and nifedipine CR therapy in patients with essential hypertension Full Text
International Journal of General Medicine, 09/21/2012
Clinical Article
Shimizu Y et al. – Telmisartan produced a favorable metabolic effect in hypertensive patients without preexisting metabolic disorders. Addition of nifedipine controlled release (CR) produced further blood pressure (BP)–lowering effects, and resulted in maintenance of metabolic indices.
Methods
- Sixteen patients with essential hypertension, who had not undergone antihypertensive therapy in the previous 6 months, were studied.
- Patients were initiated on telmisartan (40 mg/day).
- If their office BP was not reduced to 140/90 mmHg after 6 weeks, nifedipine CR (20–40 mg per day) was added for 18 weeks.
- The other patients whose BP had achieved the target of 140/90 mmHg, continued only telmisartan.
Results
- Telmisartan reduced BP (174 ± 13/92 ± 10 to 143 ± 22/78 ± 11 mmHg; P < 0.01) at 6 weeks in 16 patients, but eight patients did not achieve target BP levels and required addition of nifedipine.
- Telmisartan also resulted in a reduction in the homeostatic model assessment of insulin resistance (HOMA–IR) (1.30 ± 0.65 to 1.10 ± 0.42; P < 0.05) at 6 weeks, but did not affect adiponectin or leptin levels.
- Addition of nifedipine (n = 8) resulted in a reduction in BP (158 ± 18/80 ± 13 to 131 ± 8/73 ± 13 mmHg; P < 0.01) at 18 weeks, but did not affect the HOMA–IR (1.10 ± 0.40 to 1.02 ± 0.56; ns).
- In patients who did not require addition of nifedipine (n = 8), BP levels remained nearly identical at 18 weeks (127 ± 13/73 ± 9 to 128 ± 13/68 ± 8 mmHg; ns), and HOMA–IR also remained nearly identical.
