Effect of metformin combined with telmisartan on blood pressure and insulin in obese hypertensive patients with impaired glucose tolerance

Abstract

Objective To investigate the clinical efficacy of metformin combined with telmisartan in obese hypertensive patients with impaired glucose tolerance, and to observe the effect of metformin combined with telmisartan on blood pressure and insulin. Methods 92 patients of obese hypertensive with impaired glucose tolerance were included in this study, they were randomly divided into two groups according to the digital table, 46 cases in each group.The two groups of patients were given symptomatic treatment, on this basis, the control group was given telmisartan, the observation group was given telmisartan and metformin tablets.The blood glucose levels, fasting insulin, 2 h postprandial insulin and body mass index were measured before treatment and after treatment for 12 weeks.The insulin sensitivity index (ISI) and insulin resistance index (HOMA-IS) were measured 12 weeks after treatment.The clinical antihypertensive effect and adverse reactions were analyzed. Results After treatment for 12 weeks, the levels of fasting blood glucose, and 2h postprandial glucose, fasting insulin, 2h postprandial insulin and body mass index of the observation group were (5.11±0.38)mmol/L, (7.12±0.75)mmol/L, (22.47±4.26)mmol/L, (161.25±41.75)mU/L, (25.78±2.11)kg/m2, respectively, which in the control group were (5.59±0.41)mmol/L, (8.36±0.71)mmol/L, (26.75±4.17)mU/L, (179.88±42.65)mU/L, (27.69±2.28)kg/m2, respectively, the differences were statistically significant (t=5.82, 8.14, 4.86, 2.11, 4.17, P=0.00, 0.00, 0.00, 0.03, 0.00). After treatment for 12 weeks, the ISI and HOMA-IS of the observation group were (-2.79±0.38), (3.07±1.02), respectively, which of the control group were (-3.15±0.47), (3.65±1.25), respectively, the differences were statistically significant (t=4.03, 2.43, P=0.00, 0.01). The indicators of the two groups were significantly improved compared with before treatment (P<0.05). The total effective rate of the observation group was 76.09%, which was significantly higher than 41.30% of the control group (χ2=11.57, P=0.00). There was no serious adverse reaction during the treatment period. Conclusion Metformin combined with telmisartan in the treatment of obese hypertensive patients with impaired glucose tolerance can help to improve the body mass index, blood pressure, blood glucose, insulin and other indicators, and has certain safety. Key words: Metformin; Telmisartan; Obesity; Hypertension; Impaired glucose tolerance