Effects Of Telmisartan, Angiotensin Ii Receptor Blocker, On Endothelial Function And Aortic Stiffness In Morning Hypertensive Patients With The Metabolic Syndrome And Obstructive Sleep Apnea

Morning hypertension and the metabolic syndrome (MetS) are recognized as a risk factor for cardiovascular disease, and are reported to be associated with obstructive sleep apnea (OSA). Recently it has been reported that telmisartan has an action of PPAR - γ agonist. We assessed the effects of telmisartan on endothelial function and aortic stiffness in morning hypertensive patients with MetS and OSA. Thirty untreated morning hypertensive patients with MetS and mild or moderate OSA (an apnea-hypopnea index [AHI] 5 – 30) were randomized to receive telmisartan (Telmisartan group, 20 - 40 mg/day, n=15) or amlodipine (Amlodipine group, 2.5 - 5 mg/day, n=15). Flow-mediated dilatation (FMD) and nitroglycerin-induced dilatation (NID) of brachial artery were measured by using ultrasound system. Pulse wave velocity (PWV) was measured by using oscilometric technique. We assessed insulin resistance by HOMA-IR, and measured high sensitivity C-reactive peptide (hsCRP) and thiobarbituric acid reactive substance (TBARS) a...