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Study Reveals Best Blood Pressure Drugs for Diabetics

Update Date: Jul 08, 2013 12:57 PM EDT
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A new study has linked two blood pressure drugs used to reduce blood pressure in people with diabetes to lower risk rates of heart attack, stroke of heart failure.

The study, published in the Canadian Medical Association Journal, involved data for 54,186 Ontario residents with diabetes who were over age 65 who took angiotensin-receptor blockers between April 2001 and March 2010.

Researchers wanted to see if there was a lower risk of heart disease in people taking telmisartan compared with other drugs in the same class. The findings revealed that telmisartan and valsartan were associated with a significantly lower risk of hospitalization for heart attack, stroke or heart failure compared with other angiotensin-receptor blockers.

Disease-related vascular illnesses are the main causes of death among with people type 2 diabetes. Angiotensin-receptor blockers include telmisartan, valsartan, candesartan, irbesartan and losartan.  These medications are generally used interchangeably to control blood pressure, but previous small studies suggest that telmisartan has slightly different properties than other angiotensin-receptor blockers and may improve cardiovascular health, according to researchers.

"Our findings suggest that statistically important differences exist in the effectiveness of angiotensin-receptor blockers when used for the prevention of diabetes-related macrovascular disease, and that a class effect for these agents may not be assumed when used for this purpose in clinical practice," Dr. Tony Antoniou, Department of Family and Community Medicine, St. Michael's Hospital, Toronto, wrote in the study.

"Although angiotensin-receptor blockers share common structural features, important pharmacologic differences exist between the drugs that may explain our results," the authors explained. "Specifically, at clinically attainable serum concentrations, telmisartan is unique among these drugs in its ability to structurally interact with and activate the PPARg receptor, a ligand-activated transcription factor that regulates lipid metabolism and insulin sensitivity."

Researchers said the next step is to conduct randomized controlled trials and large observational studies that examine the cardiovascular health and deaths in patients taking different angiotensin-receptor blockers.

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