Effect of telmisartan on cholesterol levels in patients with hypertension - Saga telmisartan aggressive research (STAR)

Saga Telmisartan Aggressive Research (STAR) is a single-arm, prospective multi-center trial to evaluate the effectiveness of treatment with telmisartan in patients with hypertension. A total of 197 patients with a systolic blood pressure of >= 140 or a diastolic blood pressure of >= 90 mmHg were enrolled in this study, and were prescribed 20 to 80 mg/day of telmisartan for 6 months. In all patients, both systolic and diastolic blood pressures decreased (159 +/- 20 to 135 +/- 12 mmHg, p < 0.0001, 87 +/- 12 to 75 +/- 8 mmHg, p < 0.0001, respectively). In addition, total cholesterol (TC) levels decreased from 200 +/- 40 to 188 +/- 33 mg/dl (p < 0.05). In patients with TC >= 220 mg/dl, the change was more striking (249 +/- 33 to 204 +/- 31 mg/dl, p < 0.0001). Even in patients receiving statins, TC levels still were decreased (216 +/- 51 to 190 +/- 31 mg/dl, p < 0.02). In addition, TC levels were also decreased even in patients receiving telmisartan in exchange for other ARBs with TC >= 220 mg/d. Triglyceride (TG) levels were decreased (270 +/- 199 to 175 +/- 74 mg/ dl, p < 0.005) in patients with TG levels >= 150 mg/ dl. Fasting blood glucose (FBG) was decreased (158 +/- 68 to 138 +/- 60 mg/dl, p < 0.05) in patients with FBG >= 110 mg/dl. These results suggest that telmisartan may have favorable effects on lipid and glucose metabolism, in addition to lowering blood pressure. The profound effect of telmisartan to lower cholesterol suggests a potential use in hypertensive patients with dyslipidemia.