Abstract 3626: Partial Peroxisome Proliferators-Activated Receptorγ (PPARγ) Agonistic Action of Angiotensin II Type 1 Receptor Blocker Improves Metabolic Features and Reduce Microalbuminuria through Suppression of Low-Grade Inflammation in Hypertensive Patients with Metabolic Syndrome
Introduction. The additional benefit of partial peroxisome proliferators-activated receptorγ (PPARγ) agonistic action of angiotensin type-1 receptor blockade (ARB) has not been fully investigated in hypertensive patients with metabolic syndrome. We investigated whether telmisartan, ARB with partial PPARγ agonistic action, has additional effects on metabolic factors, and high-sensitive C-reactive protein (hs-CRP), and microalbuminuria, compared with ARB without PPARγ agonistic action, valsartan, in such patients.
Method. The study was an open-label, randomized, multicenter trial. Fifty-three patients with metabolic syndrome, taking valsartan were recruited. All patients with valsartan were randomly assigned to replace by telmisartan (20 – 80mg/day) (n=30, Telmisartan group,) or to keep valsartan (40–160mg/day) (n=23, Control group). At the baseline and 12 weeks after randomization, various parameters related to metabolic syndrome. Lipoprotein profile was evaluated using polyacrylamide gel disc electrophoresis.
Results. There was no significant change in blood pressure and glucose homeostasis between the baseline and 12 weeks after randomization in both groups. There was a significant change in lipoprotein distribution (midband lipoprotein fraction: −16%, p= 0.005; HDL fraction: +2.2%, P=0.61; LDL fraction: +4.4%, P=0.029) with an increase in high molecular weight adiponectin (+9.3%, P=0.046), while there were no significant changes in these factors in valsartan group. The reductions of microalbuminuria (−19%, P=0.008) and hs-CRP (−23%, P=0.005) were significantly greater in the telmisartan group than those in the varsaltan group. The reductions in microalbuminuria and hs-CRP were significantly correlated with each other (γ=0.428, P=0.021), in dose-dependent fashion of telmisartan (>40mg/day).
Conclusion. Partial agonistic action of PPAR γ agonist with ARB, achieve more favorable effect on metabolic features and microalbuminuria through suppression of inflammatory reaction in hypertensive patients with metabolic syndrome.