The effect of
telmisartan on
ambulatory blood pressure, plasma neurohormonal parameters, and oxidation of
serum albumin has not been investigated in
hemodialysis (HD) patients. Thirteen
hypertensive HD patients were treated with 40 mg
telmisartan once daily, and 24-h
ambulatory blood pressure monitoring was performed after 0, 4, and 8 weeks of treatment.
Plasma renin activity, plasma
aldosterone concentration (PAC),
brain natriuretic peptide (BNP) level, and serum oxidized
albumin level were determined at the same time points. Serum
telmisartan concentration was also measured at 4 and 8 weeks.
Telmisartan significantly reduced
systolic blood pressure and
diastolic blood pressure (both awake and
sleeping) after 4 weeks, and these pressures showed a further significant decrease after 8 weeks. Plasma levels of
aldosterone, BNP, and serum oxidized
albumin were markedly decreased after 4 weeks and these lower levels were maintained at 8 weeks. The trough serum
telmisartan concentration was not significantly different at 8 weeks compared with 4 weeks. Throughout the treatment period, there were no significant
adverse effects.
Telmisartan effectively lowers
blood pressure and reduces PAC, BNP, and
oxidative stress and is safe and well-tolerated by HD patients. A long-term study in a large population is required to determine the influence of
telmisartan therapy on
cardiovascular mortality and
morbidity in HD patients.
