Background and purpose: Although their primary mechanism of action is blood pressure lowering, emerging data suggest that select angiotensin receptor blockers (ARBs), which partially activate the peroxisome proliferator-activated receptor gamma (PPAR-gamma), may effectively treat insulin resistance and dyslipidemia without the toxicity sometimes associated with full PPAR-gamma agonists. Since up to 50% of the patients with ischemic stroke and transient ischemic attack harbor insulin resistance, drugs that simultaneously control hypertension and insulin resistance could be particularly useful for stroke prevention.
Summary of review: This review presents the experimental and preliminary clinical evidence supporting a promising role for partial PPAR-gamma agonist ARBs in treating insulin resistance and the metabolic syndrome in patients with ischemic cerebrovascular disease.
Conclusion: Partial PPAR-gamma agonist ARBs by virtue of their multiple beneficial mechanisms of action could provide a single multipronged strategy for reducing future vascular events in persons with, or at risk for, stroke.
(c) 2008 S. Karger AG, Basel.