Department of Cardiology and Angiology, University Hospital Erlangen, Germany.
Cytokine. 2013 May;62(2):290-6. doi: 10.1016/j.cyto.2013.02.001. Epub 2013 Mar 28.
Hypertension is one of the most prominent risk factors for coronary artery disease (CAD). Treatment of hypertension is therefore important for reducing cardiovascular events and the progression of atherosclerosis. Several treatment strategies are common in clinical practice for example the use of ACE-blockers or angiotensin receptor II blockers (ARBs), so called sartans. Telmisartan, belonging to the class of ARBs, was shown to exert anti-inflammatory effects besides the blood pressure lowering.
In this work, two separate substudy groups of hypertensives were compared. 16 patients with arterial hypertension have been treated with telmisartan (initial 40 mg Kinzalmono®) for 7.3 ± 4.4 months. The telmisartan group was compared to a matched control group including 31 hypertensive patients without telmisartan treatment with a follow up period of 1.9 ± 0.5 years. Serum samples from the beginning and the end of follow up were analyzed with Luminex® technology for 26 cytokines and chemokines. The baseline scores of coronary artery calcification (CAC) were gathered by multislice detector computer tomography.
After 7 months of telmisartan treatment and 2 years in control patients most of the measured analytes did not change significantly. MCP-1 (P=0.001; P<0.001) was increased significantly in both telmisartan and control group. The relative decrease in IP-10 and TNF-α levels was observed in telmisartan group, as opposed to the increase in control (telmisartan vs. control P=0.048; P=0.01). No linear rank-correlation between measured analytes and the initial CAC was found.
Telmisartan reduced blood pressure in patients with atherosclerosis and arterial hypertension within a short time period, whereas the inflammatory status of these patients remained largely unchanged. An involvement of telmisartan in the regulation of inflammatory and anti-inflammatory mediators in the context of CAD and CAC is possible, but cannot clearly be assumed based on the present findings.
高血压是冠心病（CAD）最重要的危险因素之一。因此，治疗高血压对于降低心血管事件和动脉粥样硬化进展非常重要。在临床实践中，有几种常见的治疗策略，例如使用血管紧张素转换酶抑制剂或血管紧张素受体 II 阻滞剂（ARB），即所谓的沙坦类药物。替米沙坦属于 ARB 类药物，除了降低血压外，还具有抗炎作用。
在这项工作中，将两组不同的高血压亚组进行了比较。16 例高血压患者接受替米沙坦（初始剂量为 40mg Kinzalmono®）治疗 7.3±4.4 个月。将替米沙坦组与未接受替米沙坦治疗的 31 例高血压患者的匹配对照组进行比较，随访时间为 1.9±0.5 年。使用 Luminex®技术分析开始和随访结束时的血清样本，检测 26 种细胞因子和趋化因子。通过多排探测器计算机断层扫描收集冠状动脉钙化（CAC）的基线评分。
替米沙坦治疗 7 个月和对照组患者 2 年后，大多数测量的分析物没有明显变化。MCP-1（P=0.001；P<0.001）在替米沙坦组和对照组中均显著增加。与对照组相比，替米沙坦组 IP-10 和 TNF-α 水平的相对下降，而对照组则增加（替米沙坦与对照组相比，P=0.048；P=0.01）。未发现测量分析物与初始 CAC 之间存在线性等级相关。
替米沙坦在短时间内降低了动脉粥样硬化和高血压患者的血压，而这些患者的炎症状态基本没有变化。替米沙坦可能参与了 CAD 和 CAC 背景下的炎症和抗炎介质的调节，但根据目前的研究结果，不能明确假设这一点。
