Comparison of therapies between fixed-dose telmisartan/hydrochlorothiazide and
losartan/hydrochlorothiazide in patients with mild to moderate hypertension.
Author(s): Minami J(1), Furukata S, Ishimitsu T, Matsuoka H.
Affiliation(s): Author information:
(1)Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical
University, Tochigi, Japan.
Publication date & source: 2009, Int Heart J. , 50(1):85-93
Among angiotensin receptor blockers (ARBs), telmisartan is suggested to function
as a partial agonist of peroxisome proliferator-activated receptor-gamma (PPAR
gamma) and to improve lipid and glucose metabolism. Clinical benefits of
telmisartan over other ARBs may be apparent in combination with diuretics, which
have harmful influences on lipid and glucose metabolism. In the present study, 21
patients treated with mild to moderate hypertension (13 women and 8 men aged 63.1
+/- 11.6 years) underwent a 24-week treatment period with telmisartan 40 mg and
HCTZ 12.5 mg once daily, or a 24-week treatment period with losartan 50 mg and
HCTZ 12.5 mg once daily, without a wash-out period, in a quasi-randomized
cross-over manner. Their ambulatory blood pressure and metabolic parameters were
measured after the 2 treatment periods. Ambulatory systolic and diastolic blood
pressures did not differ significantly between the 2 treatment periods during 24
hours, daytime, night-time, and early-morning hours (06:00-08:00). Serum uric
acid was insignificantly higher in the treatment period with telmisartan/HCTZ
than in the treatment period with losartan/HCTZ (P = 0.086). Although serum total
cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein
cholesterol did not differ significantly, serum triglycerides were slightly
higher in the treatment period with telmisartan/HCTZ than in the treatment period
with losartan/HCTZ (P = 0.060). Parameters of glucose metabolism did not differ
significantly between the 2 treatment periods. In conclusion, antihypertensive
efficacy was similar between the 2 regimens throughout 24 hours, despite
different elimination half-lives of telmisartan and losartan. Although
telmisartan is suggested to function as a partial agonist of PPARgamma, no
clinical benefit was found in combination with HCTZ with respect to lipid and
glucose metabolism.
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