title: Effects of telmisartan on inflammatory cytokines and coronary plaque component as assessed on integrated backscatter intravascular ultrasound in hypertensive patients.
abstract: BACKGROUND
  Telmisartan has unique pleiotropic effects in addition to renin-angiotensin system (RAS)-inhibition effects. The aim of this study was to evaluate the effects of telmisartan on the coronary plaque component and local inflammatory cytokines.
  
  
  RESULTS
  A total of 50 patients with hypertension were randomized to 2 groups: the telmisartan group (additional treatment with telmisartan 80mg/day, n=25) or the control group (additional treatment with other anti-hypertensive drugs except RAS blockers, n=25) for 6 months. Tissue characteristics of target coronary plaque were analyzed using integrated backscatter intravascular ultrasound (IB-IVUS) before and after treatment. Plasma levels of inflammatory cytokines sampled in the coronary sinus (CS) and peripheral vein were also measured. Significant increases in fibrous volume (51.2±10.4 to 58.3±7.7%, P=0.03) and reductions in lipid volume (38.4±12.4 to 32.8±9.7%, P=0.03) were observed on IB in the telmisartan group, while there were no significant changes in the plaque component in the control group. CS levels of inflammatory cytokines (matrix metalloproteinase [MMP]3, tumor necrosis factor-α, high-sensitivity C-reactive protein and MMP9) were lower after than before treatment in the only telmisartan group (7.7±6.1 to 5.5±4.9ng/ml, 3.1±1.9 to 2.3±2.0pg/ml, 5.6±6.0 to 2.2±2.4mg/L, 36.1±39.3 to 19.9±27.5ng/ml, P=0.02, P=0.03, P=0.04, P=0.07, respectively).
  
  
  CONCLUSIONS
  Decreased local inflammatory response and plaque stabilization on IB imaging were observed after 6 months of telmisartan treatment. These findings might be associated with local anti-inflammatory and anti-arteriosclerotic effects of telmisartan.
authors.affiliation: Department of Cardiovascular Medicine, Tokushima University Hospital.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soeki
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Niki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taketani
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Oeduka
authors.forename: Kenya
authors.initials: K
authors.lastname: Kusunose
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ise
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwase
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Yamada
authors.forename: Masataka
authors.initials: M
authors.lastname: Sata
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000008:administration & dosage*; D001565:Benzoates / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D016207:Cytokines / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D018836:Inflammation Mediators / Q000378:metabolism*; D008297:Male; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D000077333:Telmisartan; D018084:Ultrasonography, Interventional
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D016207:Cytokines; D018836:Inflammation Mediators; D000077333:Telmisartan