La hipertensión coexiste frecuentemente con el daño renal y con alteraciones en el metabolismo de los lípidos y la glucosa. Los antagonistas de los receptores de la angiotensina II (ARA-II) no sólo disminuyen la proteinuria y el daño renal, sino que pueden tener efectos metabólicos beneficiosos. Además, algunos ARA-II, como el telmisartán tienen similitud estructural con las glitazonas y son agonistas parciales de los receptores PPAR-γ (peroxisome proliferator-activated receptor-γ). Estos receptores aumentan la sensibilidad a la insulina, disminuyendo la glucemia y la concentración plasmática de ácidos grasos. De acuerdo con esto, el telmisartán disminuye los valores de colesterol total, LDL, glucosa e insulina. Sin embargo, otros ARA-II sin esta acción sobre los PPAR-γ reducen la incidencia de diabetes. Por tanto, debemos esperar los resultados de los estudios en marcha ONTARGET y TRANSCEND para comprobar si este favorable perfil metabólico de telmisartán se traduce en beneficios adicionales en términos de reducción de riesgo cardiovascular.
Palabras clave
Angiotensina
Diabetes
Colesterol
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