Abstract:

No study has analyzed the extent of weight reducing ability among the “peroxisome proliferator activated receptor-gamma” (PPAR-γ) activating ARBs – Telmisartan and Irbesartan in black hypertensive of African origin. This retrospective cohort study was designed to delineate the extent of weight reducing effect of these PPAR-γ activating ARBs and how it correlates with BP reduction observed with these ARBs in black hypertensive. A total of 26 case notes of patients (15 men, 11 women; mean age 58.9±1.8 years) with diagnosis of hypertension were reviewed and the study attained a power of 96%. The patients whose case notes were reviewed were naïve to ARBs before commencing either telmisartan or irbesartan and did not have any metabolic disease like diabetes or thyroid disease which could interfere with body weight reading. They all took either telmisartan 80mg or irbesartan 150mg for at least a 6 month review period. Body weight were significantly reduced more in the telmisartan (n = 13) treatment group compared to the irbesartan (n = 13) treatment group [change from baseline; -1.51±0.46Kg (-1.68%), P=0.006 vs. -0.96±0.15Kg (-1.05%), P<0.001]. Both treatment effectively controlled blood pressure (mean BP after 6 months treatment: Telmisartan 126/83mmHg; Irbesartan 133/84mmHg). In the telmisartan group there were no correlation between either change in SBP and change in body weight (r = -0.220, P = 0.471) or change in DBP and change in body weight (r = -0.050, P = 0.870), but a significant positive correlation was observed between both change in SBP and change in body weight (r = 0.538, P = 0.058) and change in DBP and change in body weight (r = 0.610, P = 0.027) in the irbesartan treatment group. Both telmisartan and irbesartan reduced body weight in hypertensive black patients and this reduction in body weight may contribute to the power demonstrated by irbesartan to get patients to BP goal. Hence hypertensive blacks could also benefit from the established end-organ protection benefits of both telmisartan and irbesartan.

Key words: Hypertension; Telmisartan; Irbesartan; Body weight; Adiponectin; PPAR-γ.

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