Olmesartan ameliorates hepatic insufficiency and serum TGF-β1 level in hypertensive patients with non-alcoholic fatty liver disease

Background：Because of westernization of lifestyle in recent years, the number of patients with lifestyle diseases, including obesity, metabolic syndrome, hypertension, dyslipidemia and diabetes mellitus, are increasing steadily. Recently, it has been noted that non‒alcoholic fatty liver disease（NAFLD）alone can cause liver cirrhosis or liver cancer. Angiotensin typeⅡ receptor blocker （ARB）is widely used in clinical practice as an antihypertensive agent. In addition to the antihypertensive effect by inhibiting the renin‒angiotensin system, ARB has been demonstrated to protect the multiple organs damage, including brain, heart and kidney. In recent years, many reports suggest that the renin‒angiotensin system is involved in the development of liver fibrosis. Objectives：We examined the protective effect of olmesartan on hepatic insufficiency and hepatic fibrosis marker in hypertensive patients with NAFLD. Methods：Olmesartan was administered to eleven hypertensive patients with NAFLD for 12 weeks. Results：Both office systolic blood pressure and diastolic blood pressure decreased from 141±3/82±2 mmHg to 130±7/76±4 mmHg（p＝0.035）. AST decreased significantly from 48.8±4.5 IU/L to 42.2±4.6 IU/L（p＝0.011）, AST from 71.7±7.8 IU/L to 59.8±8.5 IU/L（p＝0.046）, γ‒GTP from 102.3±21.6 IU/L to 90±20.3 IU/L（p＝0.049）. Finally, regarding TGF‒β1, a significant change was observed from 14898±3101 pg/mL to 10738±2405 pg/mL（p＝0.017）. Conclusions：Olmesartan ameliorates hepatic insufficiency in hypertensive patients with NAFLD. Olmesartan may not only have a class effect of ARB but also have a drug effect, especially on NAFLD.