OBJECTIVE: We performed this meta-analysis determining the antihypertensive effect of telmisartan versus perindopril in patients with essential hypertension. BACKGROUND: The comparison of antihypertensive effects between telmisartan and perindopril were controversial. METHODS: Pubmed, Web of Science, and Cochrane Central were searched for all published studies. RESULTS: The antihypertensive effects were assessed in 753 patients included in 7 trials with a mean follow-up of 20 ± 16 weeks. There was no signifi cant difference between telmisartan and perindopril in reduction of systolic blood pressure (SBP, weighted mean differences (WMD) 0.02 (95% confi dence interval (CI), -2.78, 2.81) mmHg, p > 0.05). The reduction of diastolic BP (DBP) treated with telmisartan was greater than perindopril in these patients (WMD -2.05 (95% CI, -2.60, -1.49) mm Hg, p < 0.001). Considering the effects of different doses on BP reduction, a sub-analysis was performed. The reduction of DBP treated with 40 mg/day telmisartan was greater than 4-5 mg/day perindopril (WMD -2.18 (95% CI, -2.83, -1.53) mmHg, p < 0.001). There was no difference for SBP reduction treated with 40 mg/day telmisartan or 4-5 mg/day perindopril (p > 0.05). CONCLUSION: The reduction of DBP is greater treated with telmisartan than perindopril in patients with essential hypertension (Tab. 2, Fig. 4, Ref. 34).