Advances in Therapy

, Volume 28, Issue 8, pp 698–706

Influence of telmisartan on insulin response after glucose loading in obese patients with hypertension: ARB Trial of hypertension in obese patients with hyperinsulinemia assessed by oral glucose tolerance test (ATHLETE)

  • Yutaka Mori
  • Takaaki Tanaka
  • Kenichi Matsuura
  • Junichi Yokoyama
  • Kazunori Utsunomiya
Original Research

DOI: 10.1007/s12325-011-0040-2

Cite this article as:
Mori, Y., Tanaka, T., Matsuura, K. et al. Adv Therapy (2011) 28: 698. doi:10.1007/s12325-011-0040-2
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Abstract

Introduction

The number of patients with both hypertension and obesity has been increasing in Japan. Many of these patients may also have insulin resistance. Telmisartan, an angiotensin II receptor blocker (ARB), selectively activates peroxisome proliferatoractivated receptor (PPAR)-gamma, and this effect is considered to markedly improve insulin resistance in obese patients with hypertension. We compared the antihypertensive and insulin resistance-improving effects of telmisartan with those of candesartan and valsartan in this patient population.

Methods

Twenty-eight elderly patients with an average body mass index (BMI) of 27.1 kg/m2 were enrolled in this 6-month study. Patients were randomly selected to either switch from candesartan or valsartan to telmisartan or to continue with their current ARB. A 75 g oral glucose tolerance test (OGTT) was performed before and after switching, and the effect of telmisartan on the insulin response to glucose loading was investigated.

Results

There was no significant difference in blood pressure between the two groups after drug administration, but glucose tolerance significantly improved in the telmisartan group. The hyperinsulin response to glucose loading also significantly improved in those taking telmisartan, as well as homeostasis model assessment of insulin resistance (HOMA-IR). These changes were not observed in the control group.

Conclusion

In patients with hypertension and obesity showing insulin resistance, treatment with telmisartan significantly improved the hyperinsulin response to glucose loading. Telmisartan may therefore be beneficial in these patients.

Keywords

hypertensioninsulin resistanceobesityoral glucose tolerance testPPAR-gamma activationtelmisartan

Copyright information

© Springer Healthcare 2011

Authors and Affiliations

  • Yutaka Mori
    • 1
    • 2
  • Takaaki Tanaka
    • 2
  • Kenichi Matsuura
    • 3
  • Junichi Yokoyama
    • 3
  • Kazunori Utsunomiya
    • 3
  1. 1.Division of Diabetes and Endocrinology, Department of Internal MedicineJikei University School of MedicineKomae City, TokyoJapan
  2. 2.Department of Clinical Research, National Hospital OrganizationUtsunomiya National HospitalUtsunomiya City, TochigiJapan
  3. 3.Division of Diabetes and Endocrinology, Department of Internal MedicineJikei University School of MedicineKomae City, TokyoJapan