The Effect of Telmisartan and Irbesartan on Body Weight and its Contribution to Blood Pressure Control in Hypertensive Black Patients: A Retrospective Cohort Study

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