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| |  AIIA: Angiotensin II Antagonist Telmisartan Fights Stiffening Arteries In Hypertensive Diabetics By Malcolm K. Seymour Special to DG News
LONDON, UNITED KINGDOM -- April 6, 2001 -- In patients with type 2 diabetes and essential hypertension, the angiotensin (AT) II antagonist telmisartan not only effectively lowered blood pressure compared with placebo, but also significantly decreased arterial stiffness, an important risk factor for cardiovascular events. Stiffness of the arteries increases as individuals age both in the presence of hypertension and in diabetes. Increasing arterial stiffness increases the risk of cardiovascular disorders including left ventricular hypertrophy and stroke, and so is a key cardiovascular risk factor. Diabetic patients are already predisposed to atherosclerosis and cardiovascular disease, so an older diabetic suffering from hypertension and increasing arterial stiffness is particularly at risk. However, some antihypertensive drugs may decrease arterial stiffness (that is, improve compliance of the vessels) and so could be a valuable aid to lowering the incidence of cardiovascular events in such patients. A randomised, double-blind placebo-controlled crossover study conducted at two centers in France aimed to find out if treatment with the antihypertensive AT II antagonist telmisartan could improve arterial compliance in patients with essential hypertension and type 2 diabetes. The study was described in a poster presented at the 4th International Symposium on Angiotensin II Antagonism in London, England by Dr R. Asmar, from Paris, France. After a two-week placebo run-in period, 28 patients were randomised to two groups, each of received telmisartan 40 mg daily or placebo for three weeks; after a two-week washout period each group received the other treatment for three further weeks. The primary outcome measure was the change from baseline in arterial stiffness, indicated by change in the carotid-femoral pulse wave velocity assessed using the proprietary Complior® system. Blood pressure and other cardiovascular variables were also measured. Pulse wave velocity - and hence arterial stiffness - was significantly reduced by telmisartan. Mean velocity fell by 0.95 meters/second (P = 0.013). In addition, mean diastolic, systolic and pulse blood pressures, both central and peripheral, were all significantly reduced by telmisartan (P<0.01 or better) Dr. Asmar and colleagues concluded that the AT II antagonist telmisartan significantly decreased arterial stiffness in addition to effectively lowering central and peripheral blood pressure compared with placebo in the hypertensive diabetic subjects.
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