Telmisartan as a metabolic sartan for targeting vascular failure.

An angiotensin II type 1 receptor blocker (ARB), telmisartan, has the unique property of activation of PPAR-gamma. This review aims to discuss clinical perspective of telmisartan for cardiovascular protection. Recent in vitro and in vivo telmisartan data in regard to metabolic regulations were overviewed. 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'.