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Telmisartan to reduce cardiovascular risk in older HIV-infected adults: a pilot study

Jordan E Lake, Sophie Seang, Theodoros Kelesidis

    HIV Clinical Trials
    |September 12, 2015
    PubMed

    Insights

    Telmisartan did not significantly improve endothelial function in HIV-infected individuals. However, some subgroups like those on abacavir or protease inhibitors showed increased flow-mediated dilation (FMD), suggesting potential benefits.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Pharmacology

    Background:

    • Individuals with HIV face elevated cardiovascular disease (CVD) risk.
    • Traditional CVD therapies require further study in this population.
    • Telmisartan, an ARB and PPAR-gamma agonist, benefits endothelial function in HIV-uninfected populations.

    Purpose of the Study:

    • To assess telmisartan's effects on endothelial function in older HIV-infected individuals at risk for CVD.
    • To evaluate changes in brachial artery flow-mediated dilation (FMD) as a measure of endothelial function.

    Main Methods:

    • A pilot study involving HIV-infected individuals aged 50+ on suppressive antiretroviral therapy (ART) with CVD risk factors.
    • Open-label telmisartan 80 mg daily for 6 weeks.
    • Brachial artery flow-mediated dilation (FMD) measured endothelial function, with the primary endpoint being the 6-week change in maximum relative FMD.

    Main Results:

    • 16 participants completed the study; 88% male, 65% non-White, median age 60.
    • Significant reductions in systolic (-16.0 mmHg) and diastolic (-6.0 mmHg) blood pressure were observed.
    • No significant overall change in FMD, but increased FMD noted in abacavir-treated, PI-treated, and non-smoking subsets.

    Conclusions:

    • Six weeks of telmisartan did not significantly alter endothelial function (FMD) in this cohort.
    • Subgroup analyses suggest potential benefits in specific patient groups (abacavir/PI users, non-smokers).
    • Further research is warranted to explore telmisartan's role in managing CVD risk factors in HIV-infected individuals.
    Abstract

    Keywords:
    Cardiovascular riskEndothelial function,HIV,

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