Differential effect of telmisartan and amlodipine on monocyte chemoattractant protein-1 and peroxisome proliferator-activated receptor-gamma gene expression in peripheral monocytes in patients with essential hypertension.

Author(s): Marketou ME, Kontaraki JE, Tsakountakis NA, Zacharis EA, Kochiadakis GE, Arfanakis DA, Parthenakis F, Chlouverakis G, Vardas PE

Affiliation(s): Cardiology Department, Heraklion University Hospital, Crete, Greece.

Publication date & source: 2011-01, Am J Cardiol., 107(1):59-63.

Publication type: Randomized Controlled Trial

Monocyte chemoattractant protein-1 (MCP-1) and peroxisome proliferator-activated receptor-gamma (PPAR-gamma) play a significant role in monocyte activation, vascular inflammation, and atherogenesis. Angiotensin receptor blockers and calcium channel blockers are antihypertensive drugs with established efficacy and a favorable safety profile. We investigated the effect of telmisartan--an angiotensin receptor blocker with PPAR-gamma agonist activity--and amlodipine on the activation state of peripheral blood monocytes with respect to MCP-1 and PPAR-gamma gene expression in hypertensives. We recruited 31 previously untreated patients with essential hypertension who were randomly assigned to receive treatment with telmisartan (n = 16) or amlodipine (n = 15). Blood samples were taken before and 3 months after therapy initiation. Mononuclear cells were isolated and mRNAs of MCP-1 and PPAR-gamma were estimated by real-time quantitative reverse transcription-polymerase chain reaction each time. The 2 treatments decreased all blood pressure components significantly (p <0.001). In contrast, in the amlodipine group, MCP-1 gene expression was significantly downregulated after treatment with telmisartan (from 21.4 +/- 20.5 to 8.1 +/- 6.5, p = 0.009), whereas the amlodipine group did not show any significant change (12.5 +/- 8.5 vs 17.6 +/- 16.4, p = NS). In addition, PPAR-gamma mRNA levels showed a significant increase in telmisartan-treated patients (from 20 +/- 18.5 to 42.6 +/- 36, p = 0.006) and no significant alterations in the amlodipine group (from 29.6 +/- 42.5 to 24.2 +/- 27.7, p = NS). In conclusion, treatment with telmisartan results in a significant attenuation of MCP-1 gene expression and an increase of PPAR-gamma gene expression in peripheral monocytes in patients with essential hypertension. Our findings may provide new insights into the cardiovascular protection of telmisartan in hypertensives. Copyright (c) 2011. Published by Elsevier Inc.