A meta-analysis of randomized trials of telmisartan versus active controls for insulin resistance in hypertensive patients.

Abstract

To determine whether telmisartan improves insulin resistance compared with other antihypertensive drugs, we performed a meta-analysis of randomized controlled trials (RCTs) of telmisartan. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through December 2013. Eligible studies were prospective RCTs of telmisartan versus other antihypertensive drugs, enrolling individuals with hypertension and reporting insulin levels and/or homeostasis model assessment-insulin resistance (HOMA-IR) as outcomes. Of 67 potentially relevant articles screened initially, 33 reports of RCTs enrolling a total of 2033 patients with hypertension were identified and included. Pooled analyses of only the eight double-blind-design trials demonstrated statistically significant reductions in percent changes of insulin levels (mean difference, -5.19%; 95% confidence interval, -8.94% to -1.43%; P = .007) and HOMA-IR (-15.34%; -26.39% to -4.28%; P = .007) with telmisartan relative to other antihypertensive drugs. When data from all the 33 trials were pooled, telmisartan was associated with statistically significant reductions in percent changes of insulin levels (-10.92%; -15.60% to -6.23%; P < .00001) and HOMA-IR (-15.89%; -22.01% to -9.78%; P < .00001) relative to other antihypertensive drugs. In conclusion, telmisartan appears to significantly improve insulin resistance compared with other antihypertensive drugs in patients with hypertension.

• Authors: Hisato Takagi, Takuya Umemoto, All-Literature Investigation of Cardiovascular Evidence Group
• Journal: Journal of the American Society of Hypertension : JASH (J Am Soc Hypertens) Vol. 8 Issue 8 Pg. 578-92 (Aug 2014) ISSN: 1878-7436 [Electronic] United States
• PMID: 25151319 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: Copyright © 2014 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Benzimidazoles
• Benzoates
• Telmisartan

Topics

• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Benzimidazoles (therapeutic use)
• Benzoates (therapeutic use)
• Blood Pressure (drug effects)
• Humans
• Hypertension (drug therapy, metabolism, physiopathology)
• Insulin Resistance (physiology)
• Randomized Controlled Trials as Topic
• Telmisartan
• Treatment Outcome