Clinical Efficacy of Telmisartan in Reducing Cardiac Remodeling Among Obese Patients With Hypertension
Status:
Recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
Hypertension is closely related to metabolic abnormalities such as obesity, dyslipidemia and
diabetes. When hypertension is complicated with metabolic abnormalities, target organ damage
is more serious, the risk of cardiovascular adverse events is greater, and the treatment is
more complex. The pathophysiological mechanism of obesity-associated hypertension has its
particularity. Blood pressure control and effective control of obesity are important
therapeutic targets. At present, there are no guidelines for the treatment of
obesity-associated hypertension. Although several drugs have certain effects on fat
metabolism, they have little effect on blood pressure and have some side effects in long-term
use. Among the existing antihypertensive drugs, angiotensin II type 1 receptor (AT-1)
antagonists have shown their particularity in improving glycolipid metabolism, but strict
clinical trials are needed to confirm their effectiveness in weight loss and metabolism
improvement. Previous studies have shown that obese patients with hypertension have severe
insulin resistance, poor glycolipid metabolism and are prone to cardiovascular damage.
Telmisartan can block AT-1 receptor and partially activate PPAR-γ, increase the expression of
PPAR-γ target gene in preadipocytes, improve the function of visceral adipose tissue, and
effectively prevent obesity-related cardiovascular diseases. It is presumed that telmisartan
can act as a PPAR-γ agonist in clinic by altering the metabolic components and insulin
sensitivity, but there is no clinical evidence for this. On the basis of previous studies,
this study aims to evaluate the clinical efficacy of telmisartan or amlodipine in controlling
blood pressure, reducing fat accumulation, improving insulin sensitivity, and reducing
cardiac remodeling in obese patients with hypertension by prospective cohort study.
Phase:
N/A
Details
Lead Sponsor:
First Affiliated Hospital Xi'an Jiaotong University