EFFECT OF ANGIOTENSIN II RECEPTOR BLOCKER ON HEART, VESSEL AND METABOLIC PARAMETERS IN HYPERTENSIVE PATIENTS: COMPARATIVE STUDY WITH TELMISARTAN AND VALSARTAN: PP.33.322

Background: Angiotensin II receptor blockers (ARBs) are known to be effective in improving heart structure, vascular functions and metabolic indices, but few clinical comparative studies with different ARBs have been performed. The aim of this study is to compare those effects between hypertensives who were treated with telmisartan and valsartan. Methods: The subjects with essential hypertension (48.4¡ 3/4 9.6 years) were randomly assigned to take either telmisartan (80 mg/day, n = 30) or valsartan (160 mg/day, n = 30) for 12 weeks. Their anthropometric data, laboratory measurements, vascular indices and echocardiographic data were measured at the baseline and the study end. Results: Baseline characteristics were not significantly different between the two groups except carotid-femoral pulse wave velocity (cfPWV, telmisartan group vs. valsartan group; 841.2¡ 3/4 131.0 vs. 761.1¡ 3/4 104.4 cm/s, respectively, p = 0.041). Systolic and diastolic blood pressures (BP) were significantly decreased in both groups at the study end and the changes were not significantly different between the two. Compared with the baseline, telmisartan group achieved significant reductions in cfPWV (−7.6%, p = 0.023) and left ventricular mass index (LVMI, −9.6%, p = 0.018) and showed trends for reduction in total cholesterol (−5.7%, p = 0.075) and triglyceride (−13.7%, p = 0.058) at the study end, while valsartan group did not. There were no significant changes in other vascular and metabolic parameters in both groups. When we compared, however, the changes during the study between the two groups, there was the only significant difference in LVMI (p = 0.036). Conclusions: Although the level of BP reduction was similar in both groups, telmisartan significantly improved LVMI compared with valsartan and the result may be based on the significant effect of telmisartan on cfPWV. There were no significant changes in both groups regarding metabolic parameters.