Action of irbesartan on blood pressure and glucose/lipid metabolism, in hemodialysis patients with hypertension

Abstract

Akira Onishi,1 Yoshiyuki Morishita,1 Minami Watanabe,1 Akihiko Numata,1 Mikio Tezuka,2 Kosuke Okuda,3 Sadao Tsunematsu,4 Yasuhiro Sugaya,5 Shinichi Hashimoto,5 Eiji Kusano11Division of Nephrology, Department of Medicine, Jichi Medical University, Tochigi, Japan; 2Kurosu Hospital, Tochigi, Japan; 3Okuda Clinic, Tochigi, Japan; 4Yuki Clinic, Ibaraki, Japan; 5Ninomiya Central Clinic, Tochigi, JapanBackground: Irbesartan has been reported to have beneficial effects on glucose/lipid metabolism in addition to an antihypertensive effect; however, such effects have not been clarified in hemodialysis (HD) patients. We investigated the effects of irbesartan on blood pressure (BP) as well as glucose/lipid metabolism, in HD patients with hypertension.Methods: Seventeen HD patients with hypertension, aged 62.7 ± 12.5 years, were treated with daily oral administration of 50 to 100 mg of irbesartan for 12 weeks. Then, the changes of BP as well as glucose metabolism (random serum glucose level and serum glycosylated hemoglobin [HbA1c] level) and lipid metabolism (serum low-density lipoprotein cholesterol [LDL-chol] level, serum high-density lipoprotein cholesterol [HDL-chol] level, and serum triglyceride [TG] level) were evaluated.Results: Irbesartan significantly reduced systolic BP (154.9 ± 12.8 to 139.4 ± 13.1 mmHg (P < 0.01) and diastolic BP (78.9 ± 9.1 to 72.2 ± 9.7 mmHg, P < 0.01). It also reduced LDL-chol (77.6 ± 19.1 to 72.0 ± 18.6 mg/dL, P < 0.05), whereas it did not significantly affect random serum glucose (129.3 ± 46.9 mg/dL to 130.6 ± 47.2 mg/dL), HbA1c (5.58% ± 1.41% to 5.49% ± 1.11%), TG (104.3 ± 65.8 mg/dL to 100.2 ± 59.9 mg/dL), or HDL-chol (44.8 ± 17.1 mg/dL to 45.7 ± 15.6 mg/dL).Conclusion: Irbesartan is effective for BP control and may have beneficial effects on lipid metabolism in HD patients.Keywords: irbesartan, hemodialysis patients, blood pressure, glucose/lipid metabolism