Telmisartan use reduces risk of dementia in hypertensive patients with Type 2- DM: Study

There have been various studies advocating the use of Angiotensin receptor blockers (ARBs) for managing dementia in patients with hypertension.

However, if telmisartan, an ARB with peroxisome proliferator-activated receptor γ (PPAR-γ)–modulating effects, has any more benefits compared to other ARBs remains un-documented.

A study was conducted by a group of researchers from Taiwan, to compare the prolonged outcomes of telmisartan use with the use of other ARBs in East-Asian type-2 diabetes patients with hypertension.

The researchers selected a total of 2,166,944 patients with type 2 diabetes mellitus from the National Health Insurance Research Database of Taiwan. Patients with hypertension being treated with ARBs were included in the study. Patients with a history of stroke, traumatic brain injury, or dementia were excluded.

Finally, 65,511 eligible patients were divided into 2 groups: the telmisartan group and the non-telmisartan ARB group. There were 2,280 and 9,120 patients in the telmisartan and non-telmisartan ARB groups, respectively.

Cox proportional hazard model was used to compare the risks between both the groups and the statistical significance was set at p < 0.05.

The primary outcome was the diagnosis of dementia.

The secondary outcomes included the diagnosis of Alzheimer disease and occurrence of symptomatic ischemic stroke (IS), any IS, and all-cause mortality.

The findings of the study are as follows:

· Lower risk of dementia diagnosis was seen in the patients in the telmisartan group as compared to the non-telmisartan Angiotensin receptor blockers group.

· Also, a lower risk of dementia diagnosis with ischemic stroke as a competing risk and with all-cause mortality as a competing risk was seen in the patients in the telmisartan group.

· Additionally, the telmisartan group showed a lower risk of any ischemic stroke during long-term follow-up.

The researchers concluded that telmisartan use in type-2 diabetes patients with hypertension may be associated with a lower risk of dementia and any Ischemic stroke events in an East-Asian population.

Reference:

A study titled, "Telmisartan use and risk of dementia in type 2 diabetes patients with hypertension: A population-based cohort study" by Liu C et. al published in the Plos Medicine journal.

https://doi.org/10.1371/journal.pmed.1003707