The Effect of Telmisartan on Endothelial Function and Arterial Stiffness in Patients With Essential Hypertension

BACKGROUND AND OBJECTIVES: Several studies have shown that angiotensin II receptor blockers (ARBs) improve endothelial function and arterial stiffness. Telmisartan is a highly selective ARB that activates peroxisome proliferator-activated receptor γ (PPARγ). The purpose of this study was to evaluate the effects of telmisartan, such as endothelial function, arterial stiffness, and insulin sensitivity, in patients with essential hypertension. SUBJECTS AND METHODS: Thirty-nine patients with essential hypertension were administered telmisartan (80 mg once daily) using an open-labeled and prospective protocol. The patients were examined before and 8 weeks after treatment to assess changes in flow mediated-vasodilation (FMD), pulse wave velocity (PWV), quantitative insulin-sensitivity check index (QUICKI), homeostasis model assessment (HOMA), and adiponection. RESULTS: The systolic and diastolic blood pressure (BP) decreased from 153±15 mmHg and 90±13 mmHg to 137±16 mmHg and 84±10 mmHg after telmisartan treatment, respectively (p<0.01). Telmisartan therapy increased the FMD from 7.6±3.5 to 9.0±2.8% (p<0.01). The following parameters of arterial stiffness were significantly improved after telmisartan therapy: brachial-ankle pulse wave velocity (baPWV), from 17.2±3.1 to 15.9±2.6 m/sec; heart-carotid PWV (hcPWV), from 9.7±1.8 to 9.0±1.9 m/sec; and heart-femoral PWV (hfPWV), from 11.3±1.9 to 10.7±1.9 m/sec (p<0.01). There were no changes in QUICKI, the HOMA level, and plasma adiponectin (p=NS). CONCLUSION: These results suggest that telmisartan is effective in improving endothelial function and arterial stiffness in patients with essential hypertension.