Clinical efficacy and safety of telmisartan 80 mg once daily vs. atenolol 50 mg once daily in patients with mild-to-moderate hypertension

Abstract

The objective of this open-label, parallel-group comparative study was to assess the clinical efficacy and safety of once-daily treatment for 8 weeks with telmisartan 80 mg in comparison with atenolol 50 mg on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with mild-to-moderate hypertension (morning supine SBP 141-199 mmHg, DBP 95-114 mmHg). A total of 58 patients were enrolled. The comparability of the two treatment groups was statistically documented at the beginning of the study. Telmisartan was more effective than atenolol, with a decrease in SBP of 21.7 mmHg vs. 11.8 mmHg (p ¼ 0.03) and a non-significant decrease in DBP of 14.7 mmHg vs. 10.1 mmHg. The safety profiles of both drugs were very similar; both drugs were well tolerated. In conclusion, once-daily telmisartan 80 mg is more effective than once-daily atenolol 50 mg in lowering SBP with no negative chronotropism. Furthermore, telmisartan was as well tolerated as atenolol in the treatment of mild-to-moderate essential hypertension in adults.

Review: Cardioprotective effects of telmisartan in uncomplicated and complicated hypertension

“…10 Specifically, one randomised, double-blind multicentre study evaluated long-term telmisartan administration in patients with isolated systolic hypertension, showing in more than 50% of the treated hypertensives a target reduction in SBP, defined as a systolic value < 140 mmHg or a decrease of > 20 mmHg. 11 These figures have been confirmed by a number of studies performed by employing 24-hour ABPM, [12][13][14][15][16][17][18] which additionally documented both in uncomplicated and complicated hypertension (renal insufficiency, renal failure, diabetes mellitus, obesity as well as metabolic syndrome) that 1) the drug effectively reduces BP values throughout the 24-hour average interval, 2) the antihypertensive effect follows the circadian rhythm of BP, allowing protection of the cardiovascular system against the early morning BP rise and its adverse effects on the heart and vital organs. [12][13][14][15][16][17][18][19] Two other main issues, referring to the results of the studies published so far aimed at fully characterising the antihypertensive efficacy of telmisartan, should be worthy of mention.…”

“…The first one refers to the evidence collected in comparative studies (many of them based on home or ABPM) that the drug displays BPlowering effects similar for magnitude to those of amlodipine, atenolol, enalapril, lisinopril 16,17,[20][21][22][23][24][25] but greater than those of nifedipine gastrointestinal therapeutic system (GITS), ramipril, perindopril, losartan, valsartan, eprosartan and hydrochlorothiazide. 11,15,17,18,[20][21][22][23]26,[28][29][30][31] There are similar results in the studies aimed at comparing fixed-dose combinations of telmisartan/hydrochlorothiazide vs. other Ang II blockers/diuretics combination in uncomplicated or complicated hypertensives 21,27,[32][33][34] The second issue refers to the hypothesis, currently tested in a substudy of the ONgoing Telmisartan Alone and in combination with Ramipril Global End point Trial (ONTARGET), that the favourable effects of telmisartan on 24-hour BP values may include not only the day and night BP lowering effects, but also an effective control of BP variability. 35 This is because this latter haemodynamic variable, which reflects the spontaneous beat-to-beat BP fluctuations characterising 24-hour profile, has been shown to be closely correlated with 1) target-organ damage independently of absolute BP load 36 and 2) incidence of cardiovascular events and, more in general, impact on cardiovascular mortality.…”

Telmisartan in Cardiovascular Risk Reduction

“…Ряд авторов [10,11] сравнивали антигипертензивные свойства телмисартана и β-АБ. Пришли к выводу, что телмисартан в дозе 80 мг достоверно (p=0,03) лучше снижает офисное САД, чем атенолол в дозе 50 мг (ΔСАД -21,7 мм рт.ст.…”

“…Пришли к выводу, что телмисартан в дозе 80 мг достоверно (p=0,03) лучше снижает офисное САД, чем атенолол в дозе 50 мг (ΔСАД -21,7 мм рт.ст. и -11,8 мм рт.ст., соответственно) [10]. В многоцентровом, рандомизированном, двойном слепом исследовании [11] в течение 26 нед.…”

Pharmacokinetics of Oral Doses of Telmisartan and Nisoldipine, Given Alone and in Combination, in Patients With Essential Hypertension

“…Telmisartan belongs to a new class of orally active and highly selective non‐peptide‐substituted benzimidazole AT1‐receptor antagonists 8–10 . The efficacy of telmisartan has been shown to be at least equivalent to that of many other commonly prescribed antihypertensive agents, such as losartan, 11 lisinopril, 12 enalapril, 13 atenolol, 14 and amlodipine 15 . Telmisartan has a pharmacokinetic profile that allows differentiating it from other angiotensin receptor blockers: long duration of action (mean terminal half‐life of 24 hours, the longest in its class) and high tissue penetration (illustrated by the highest volume of distribution in its class) 8,16…”