[The clinical and hemodynamic efficacy of telmisartan and enalapril in the treatment of arterial hypertension in patients with type 2 diabetes mellitus].
OBJECTIVE
To study the effects of enalapril and telmisartan on hemodynamic parameters and diastolic function (DF) of the left ventricle (LV) in patients with type 2 diabetes mellitus (DM) concurrent with arterial hypertension (AH).


METHODS
The study included 64 patients (mean age 54.3 +/- 5.2 years) with type 2 DM. For the treatment of AH, Group 1 (n = 31) received enalapril and Group 2 (n = 33) took telmisartan (micardis). Their examination comprised 24-hour blood pressure (BP) monitoring, Holter ECG monitoring, and echocardiography. The fasting and postprandial levels of blood glucose and glycosylated hemoglobin were measured to evaluate the compensation for carbohydrate metabolism.


RESULTS
In patients with type 2 DM and elevated BP, LV diastolic dysfunction was detectable in the absence of reduced contractility. LF DF, isovolumetric relaxation time, and the ratio of the peak blood flow velocity during early diastolic filling to that during atrial systole were found to correlate with HbA(1c), diastolic hypertension time index, and the diurnal duration of asymptomatic ST-segment depression. During enalapril therapy, the goal level of BP was achieved in systolic BP (SBP) in 77% of the patients and diastolic BP (DBP) in 64.5%, which was accompanied by reductions in the number of nondippers and night-pickers in 45.4% of cases with no changes in HbA(1c) and LV DF.


CONCLUSIONS
In addition to effective SBP and DBP control with the normalization of their diurnal profiles in 87.5% of the patients with abnormal circadian rhythm, the 24-week course of telmisartan therapy ensures improvements in carbohydrate metabolism and LVDF.
Tatarchenko
I P
IP
Pozdniakova
N V
NV
Mordovina
A G
AG
Morozova
O I
OI
Zaĭtseva
A V
AV
D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001565:Benzoates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000187:drug effects; D050260:Carbohydrate Metabolism / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D004656:Enalapril / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000077333:Telmisartan; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D001786:Blood Glucose; D004656:Enalapril; D000077333:Telmisartan