Effectiveness of using long-acting angiotensin II type 1 receptor blocker in Japanese obese patients with metabolic syndrome on morning hypertension monitoring by using telemedicine system (FUJIYAMA Study)

Jan 18, 2014Clinical and experimental hypertension (New York, N.Y. : 1993)

Effectiveness of a long-lasting blood pressure medicine for obese Japanese patients with metabolic syndrome using remote morning blood pressure monitoring (FUJIYAMA study)

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Abstract

Telmisartan reduced morning home blood pressure (BP) significantly more than candesartan in patients with metabolic syndrome.

Telmisartan lowered systolic home BP by 12.0 ± 8.9 mmHg, while candesartan reduced it by 8.1 ± 17.1 mmHg.
Diastolic home BP reduction was 7.4 ± 6.1 mmHg for telmisartan compared to 3.7 ± 6.8 mmHg for candesartan.
The differences in systolic and diastolic BP reductions between the two groups were statistically significant.
Telmisartan also led to a significant reduction in LDL-cholesterol levels, unlike candesartan.

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AIM: Recently, obesity patients have been diagnosed as metabolic syndrome. The aim of this study was to evaluate which angiotensin type 1 receptor blockers (ARBs), telmisartan or candesartan, is superior for the control of home blood pressure (BP) in the morning when the outpatient clinic BP was well controlled in the patients with metabolic syndrome.

METHODS: The patients with metabolic syndrome were enrolled. Home BP was monitored by using a telemedicine system. After a 2- to 4-week control period to establish baseline home BP values, these patients were randomly divided into telmisartan (20-80 mg) and candesartan (4-12 mg) groups. These end points were evaluated by using the telemedicine system during steady-state active therapy. A total of 356 patients attending 60 outpatient Japanese centers were recruited.

RESULTS: On a day of active therapy, telmisartan significantly lowered both systolic and diastolic home BP in the morning to a greater extent compared to candesartan. At the end of the study, reductions in systolic and diastolic home BP in the morning, in telmisartan group were significantly larger compared to the changes in the candesartan group (systolic; Tel: 12.0 ± 8.9 versus Can: 8.1 ± 17.1 mmHg, p = 0.0292, diastolic; Tel: 7.4 ± 6.1 versus Can: 3.7 ± 6.8 mmHg, p = 0.0053). Additionally in the telmisartan treated group, LDL-cholesterol showed significant reduction (p = 0.037), but candesartan did not.

CONCLUSION: The present study by using the telemedicine system clearly demonstrated that telmisartan has a strong effect on reducing morning home BP, and a good effect on lipid metabolism in patients with metabolic syndrome.

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Effectiveness of using long-acting angiotensin II type 1 receptor blocker in Japanese obese patients with metabolic syndrome on morning hypertension monitoring by using telemedicine system (FUJIYAMA Study)

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