A meta-analysis of randomized trials of telmisartan versus active controls for
insulin resistance in hypertensive patients.
Author(s): Takagi H(1), Umemoto T(2); All-Literature Investigation of Cardiovascular
Evidence Group.
Affiliation(s): Author information:
(1)Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka,
Japan. Electronic address: kfgth973@ybb.ne.jp. (2)Department of Cardiovascular
Surgery, Shizuoka Medical Center, Shizuoka, Japan.
Publication date & source: 2014, J Am Soc Hypertens. , 8(8):578-92
To determine whether telmisartan improves insulin resistance compared with other
antihypertensive drugs, we performed a meta-analysis of randomized controlled
trials (RCTs) of telmisartan. MEDLINE, EMBASE, and the Cochrane Central Register
of Controlled Trials were searched through December 2013. Eligible studies were
prospective RCTs of telmisartan versus other antihypertensive drugs, enrolling
individuals with hypertension and reporting insulin levels and/or homeostasis
model assessment-insulin resistance (HOMA-IR) as outcomes. Of 67 potentially
relevant articles screened initially, 33 reports of RCTs enrolling a total of
2033 patients with hypertension were identified and included. Pooled analyses of
only the eight double-blind-design trials demonstrated statistically significant
reductions in percent changes of insulin levels (mean difference, -5.19%; 95%
confidence interval, -8.94% to -1.43%; P = .007) and HOMA-IR (-15.34%; -26.39% to
-4.28%; P = .007) with telmisartan relative to other antihypertensive drugs. When
data from all the 33 trials were pooled, telmisartan was associated with
statistically significant reductions in percent changes of insulin levels
(-10.92%; -15.60% to -6.23%; P < .00001) and HOMA-IR (-15.89%; -22.01% to -9.78%;
P < .00001) relative to other antihypertensive drugs. In conclusion, telmisartan
appears to significantly improve insulin resistance compared with other
antihypertensive drugs in patients with hypertension.
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