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Telmisartan as a metabolic sartan for targeting vascular failure

Background: An angiotensin II type 1 receptor blocker (ARB), telmisartan, has the unique property of activation of PPAR-γ. Objective: This review aims to discuss clinical perspective of telmisartan for cardiovascular protection. Methods: Recent in vitro and in vivo telmisartan data in regard to metabolic regulations were overviewed. Results/conclusions: Telmisartan has direct cardiovascular end-organ protection that goes beyond blood pressure control. In addition, it ameliorates insulin resistance and hypertriglyceridemia, and thereby improves metabolic syndrome. Moreover, it reduces total cholesterol and low-density lipoprotein (LDL)-cholesterol levels, although the mechanisms have not been elucidated. The authors propose to classify this unique ARB as a ‘metabolic sartan’. To reduce cardiovascular mortality or morbidity, intense effort should be focused on aggressively modifying risk factors and the early stage of ‘vascular failure’. A metabolic sartan may be a powerful tool for targeting ‘vascular failure’.