Candesartan Reduces Inflammation, Boosts Insulin Sensitivity

Candesartan reduces inflammation, increases plasma adiponectin and improves insulin sensitivity in patients with hypertension, a new study shows. "Our study may have important implications for the treatment of patients with the metabolic syndrome," Dr. Kwang Kon Koh of Gachon Medical School in Inchon, South Korea and colleagues conclude in the March 22nd issue of the International Journal of Cardiology.

Dr. Koh and his team hypothesized that angiotensin II type 1 receptor blockers may slow coronary heart disease progression by reducing inflammation and insulin resistance. To investigate, they randomized 45 patients with mild to moderate hypertension to 16 mg candesartan daily or placebo for 2 months in a crossover, double-blind study.

They found significant correlations between baseline levels of adiponectin and insulin, as well as baseline insulin sensitivity. Levels of adiponectin also were inversely correlated with body mass index and directly correlated with HDL cholesterol.

The drug lowered plasma high sensitivity C reactive protein (hsCRP) from 1.10 mg/L at baseline to 0.70 mg/L, and reduced soluble CD40 ligand levels by 30%. Candesartan also significantly lowered fasting insulin levels compared to placebo while increasing plasma adiponectin by 15% and boosting insulin sensitivity as measured by the Quantitative Insulin-Sensitivity Check Index by 8%.

Significant correlations also were seen between percent changes in adiponectin and percent changes in insulin.

The drug produced changes suggestive of increased insulin sensitivity in several independent markers, backing up the hypothesis that all are connected by pathophysiological mechanisms, Dr. Koh and his team suggest.

"Nevertheless, conclusive demonstration of the clinical relevance of these small, but statistically significant changes will require a prospectively designed, large scale clinical trial that is beyond the scope of the current study," they conclude.
Int J Cardiol 2006;108:96-100.

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