Telmisartan improves cardiometabolic profile in obese patients with arterial hypertension.

Objective: There are several lines of evidence that telmisartan may improve cardiometabolic profile. The aim of the study was to estimate changes of insulin resistance and plasma concentrations of adipokines after long-term antihypertensive treatment with telmisartan in obese hypertensive patients.

Methods: 34 previously untreated obese adults with arterial hypertension were enrolled. Glucose cellular uptake (M value) and the M to insulin ratio (M/I value) were measured by euglycemic-hyperinsulinemic clamp technique, body fat content (by dual-energy X-ray absorptiometry method), as well as plasma concentrations of selected adipokines and cytokines were estimated before and after 6-month telmisartan therapy in 25 patients who completed the study.

Results: Telmisartan therapy was followed by 14.2% decrease of systolic and by 19.6% decrease of diastolic blood pressure. Body fat mass did not change significantly. Both M and M/I values (by 24.4 and by 38.6%, respectively) as well as plasma levels of total and high-molecular-weight adiponectin (by 10.8 and by 23.5%, respectively) increased significantly. Plasma concentrations of high-sensitivity C- reactive protein and interleukin-8 decreased significantly, while those of interleukin-6 and tumor necrosis factor-α tended to decline.

Conclusions: Telmisartan monotherapy improves cardiometabolic profile in obese hypertensive patients by improving insulin sensitivity and increasing of plasma adiponectin concentration, including its high-molecular-weight fraction, and by suppressing of microinflammation.