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Anti-inflammatory and metabolic effects of candesartan in hypertensive patients
Kwang Kon Koh1, Michael J Quon, Seung Hwan Han
1Cardiology, Gachon Medical School, Incheon, South Korea. kwangk@ghil.com
Background:
Angiotensin II type 1 (AT1) receptor blocker therapy prevented or retarded the progression of coronary heart disease. The mechanisms of this benefit may relate to the ability of AT1 receptor blockers to reduce inflammation and insulin resistance.
Methods:
We administered placebo or candesartan 16 mg daily during 2 months to 45 patients with mild to moderate hypertension. This study was randomized, double-blind, placebo-controlled, crossover in design.
Results:
Candesartan therapy significantly lowered both systolic and diastolic blood pressure. Compared with placebo, candesartan therapy significantly lowered plasma hsCRP levels relative to baseline measurements from 1.10 to 0.70 mg/l (P=0.024) and soluble CD40 ligand levels by 30+/-11% (P<0.001). There were significant inverse correlations between body mass index and baseline plasma adiponectin levels (r=-0.480, P=0.009). There were significant correlations between baseline adiponectin levels and baseline insulin (r=-0.317, P=0.034) or baseline Quantitative Insulin-Sensitivity Check Index (QUICKI), a surrogate index of insulin sensitivity (r=0.371, P=0.012). Compared with placebo, candesartan therapy significantly lowered fasting insulin levels (P=0.011) and increased plasma levels of adiponectin by 15+/-4% (P=0.012) and increased QUICKI by 8+/-2% (P=0.007). There were significant correlations between percent changes in adiponectin levels and percent changes in insulin (r=-0.340, P=0.022) or QUICKI (r=0.325, P=0.029).
Conclusions:
Candesartan therapy significantly reduced inflammation and increased adiponectin levels and improved insulin sensitivity in hypertensive patients.
Insights
Angiotensin II type 1 receptor blocker therapy, like candesartan, reduced inflammation and improved insulin sensitivity in hypertensive patients. This treatment also increased adiponectin levels, a key marker for metabolic health.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Pharmacology
Background:
- Angiotensin II type 1 (AT1) receptor blocker therapy is known to slow coronary heart disease progression.
- Potential mechanisms include reduction of inflammation and insulin resistance.
Purpose of the Study:
- To investigate the effects of candesartan on inflammation and insulin sensitivity in hypertensive patients.
- To explore the relationship between adiponectin, insulin, and insulin sensitivity.
Main Methods:
- A randomized, double-blind, placebo-controlled, crossover study involving 45 patients with mild to moderate hypertension.
- Patients received either placebo or candesartan 16 mg daily for two months.
Main Results:
- Candesartan significantly reduced systolic and diastolic blood pressure.
- Plasma levels of high-sensitivity C-reactive protein (hs-CRP) and soluble CD40 ligand decreased significantly with candesartan.
- Fasting insulin levels were lowered, while adiponectin and Quantitative Insulin-Sensitivity Check Index (QUICKI) levels increased significantly.
Conclusions:
- Candesartan therapy effectively reduces inflammation in hypertensive patients.
- The drug improves insulin sensitivity and increases adiponectin levels.
- These findings suggest a beneficial role for candesartan in managing metabolic parameters in hypertension.
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