Effects of Telmisartan on Inflammatory Cytokines and Coronary Plaque Component as Assessed on Integrated Backscatter Intravascular Ultrasound in Hypertensive Patients

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  • Yamaguchi Koji
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Wakatsuki Tetsuzo
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Soeki Takeshi
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Niki Toshiyuki
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Taketani Yoshio
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Oeduka Hiroyasu
    Medical Engineering Center, Tokushima University Hospital
  • Kusunose Kenya
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Ise Takayuki
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Iwase Takashi
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Yamada Hirotsugu
    Department of Cardiovascular Medicine, Tokushima University Hospital
  • Sata Masataka
    Department of Cardiovascular Medicine, Tokushima University Hospital

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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. Methods and 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.  (Circ J 2014; 78: 240–247)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 78 (1), 240-247, 2014

    一般社団法人 日本循環器学会

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