TY - JOUR
T1 - Practical efficacy of telmisartan for decreasing morning home blood pressure and pulse wave velocity in patients with mild-to-moderate hypertension
AU - Uchida, Haruhito
AU - Nakamura, Yoshio
AU - Kaihara, Masanobu
AU - Sugimoto, Taro
AU - Norii, Hisanori
AU - Sasaki, Motofumi
AU - Sato, Hajime
AU - Makino, Hirofumi
PY - 2004/8
Y1 - 2004/8
N2 - The current guideline-recommended blood pressure values are difficult to maintain in general practice, partly due to the lack of ideal anti-hypertensive agents. Since morning hypertension has a high correlation with cardiovascular events, expectations that telmisartan, a long-acting angiotensin-II type-1 receptor blocker (ARB), can improve cardiovascular mortality are high. In this study, the efficiency of telmisartan in reducing morning hypertension and pulse wave velocity (PWV) as a practical surrogate endpoint was investigated. Seventeen unsupervised and 7 untreated hypertensive patients were prescribed telmisartan 40 mg/day for 3 months. Medication already prescribed upon enrollment in this study was continued, with the exception of ARBs (all of which turned out to be losartan 50 mg/day), which were discontinued and replaced with telmisartan. Morning home blood pressure (MHBP), office blood pressure (OBP), and brachial-ankle PWV (baPWV) were investigated in a prospective fashion. A stratified analysis was performed regarding previous use (group L) or non-use (group N) of losartan. Over a 3-month period, telmisartan was found to significantly reduce both OBP (from 153±13/85±9 to 141±17/80±7 mmHg (p<0.01)) and MHBP (from 153±23/93±11 to 137±22/82±10 mmHg (p<0.001)). Surprisingly, 7 patients (70%) from group L achieved an OBP of less than 140/90 mmHg by simply changing their medication to telmisartan. Furthermore, baPWV fell significantly from 1,892±334 cm/s to 1,672±324 cm/s (p<0.01), which was greater than the change in baPWV estimated by OBP reduction. Here it must be mentioned that there were no significant differences between group L and group N in the courses of blood pressures and baPWV. In conclusion, telmisartan 40 mg/day was found to be effective for reducing MHBP and arterial wall stiffness in patients with mild-to-moderate hypertension, and thus may also be effective for improving cerebrocardiovascular mortality.
AB - The current guideline-recommended blood pressure values are difficult to maintain in general practice, partly due to the lack of ideal anti-hypertensive agents. Since morning hypertension has a high correlation with cardiovascular events, expectations that telmisartan, a long-acting angiotensin-II type-1 receptor blocker (ARB), can improve cardiovascular mortality are high. In this study, the efficiency of telmisartan in reducing morning hypertension and pulse wave velocity (PWV) as a practical surrogate endpoint was investigated. Seventeen unsupervised and 7 untreated hypertensive patients were prescribed telmisartan 40 mg/day for 3 months. Medication already prescribed upon enrollment in this study was continued, with the exception of ARBs (all of which turned out to be losartan 50 mg/day), which were discontinued and replaced with telmisartan. Morning home blood pressure (MHBP), office blood pressure (OBP), and brachial-ankle PWV (baPWV) were investigated in a prospective fashion. A stratified analysis was performed regarding previous use (group L) or non-use (group N) of losartan. Over a 3-month period, telmisartan was found to significantly reduce both OBP (from 153±13/85±9 to 141±17/80±7 mmHg (p<0.01)) and MHBP (from 153±23/93±11 to 137±22/82±10 mmHg (p<0.001)). Surprisingly, 7 patients (70%) from group L achieved an OBP of less than 140/90 mmHg by simply changing their medication to telmisartan. Furthermore, baPWV fell significantly from 1,892±334 cm/s to 1,672±324 cm/s (p<0.01), which was greater than the change in baPWV estimated by OBP reduction. Here it must be mentioned that there were no significant differences between group L and group N in the courses of blood pressures and baPWV. In conclusion, telmisartan 40 mg/day was found to be effective for reducing MHBP and arterial wall stiffness in patients with mild-to-moderate hypertension, and thus may also be effective for improving cerebrocardiovascular mortality.
KW - Angiotensin-II type-1 receptor blocker
KW - Ankle-brachial pressure index
KW - Arterial wall stiffness
KW - Losartan
KW - Uric acid
UR - http://www.scopus.com/inward/record.url?scp=5044235079&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=5044235079&partnerID=8YFLogxK
U2 - 10.1291/hypres.27.545
DO - 10.1291/hypres.27.545
M3 - Article
C2 - 15492473
AN - SCOPUS:5044235079
VL - 27
SP - 545
EP - 550
JO - Hypertension Research
JF - Hypertension Research
SN - 0916-9636
IS - 8
ER -