New standards in hypertension and cardiovascular risk management: focus on telmisartan

Abstract

Blockade of the renin–angiotensin system is an important approach in managing high blood pressure, and has increasingly been shown to affect cardiovascular disease processes mediated by angiotensin II throughout the cardiovascular and renal continua. Telmisartan is an angiotensin II receptor blocker (ARB) displaying unique pharmacologic properties, including a longer half life than any other ARB, that result in large and sustained reductions of blood pressure. In patients with mild-to-moderate hypertension, telmisartan has proved superior to other antihypertensive agents (valsartan, losartan, ramipril, perindopril, and atenolol) in controlling blood pressure particularly towards the end of the dosing interval. There is also clinical evidence that telmisartan reduces left ventricular hypertrophy, reduces arterial stiffness and the recurrence of atrial fibrillation, and confers renoprotection. The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET®) study has demonstrated that telmisartan has similar cardiovascular protective effects to ramipril in a large, high-risk patient population but was better tolerated. The powerful and sustained blood pressure control apparent in clinical trials, together with cardiovascular protection and tolerability demonstrated in ONTARGET® means that telmisartan may be a preferred option for patients with hypertension.

Triple drug combination of telmisartan, amlodipine and hydrochlorothiazide in the treatment of essential hypertension

“…Telmisartan is superior to olmesartan, as evident from the scientific literature thus replacing olmesartan with telmisartan in triple drug combination may have beneficial effects [21,22]. The use of combination therapy in this study was consistent with the Seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high BP.…”

A multicentre, randomized study of telmisartan versus carvedilol for prevention of atrial fibrillation recurrence in hypertensive patients

“…those who have not had any previous episodes of AF, and those with paroxysmal or persistent AF who either do not need any antiarrhythmic therapy, or those with persistent AF who do require anti-arrhythmic therapy to maintain sinus rhythm following cardioversion). [16][17][18][19] Telmisartan has the longest half-life of any ARB (approximately 24 hours) 20 and has been shown to reduce left ventricular hypertrophy (LVH) in clinical studies of hypertensive patients, [21][22][23][24] as well as in the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and Telmisartan Randomized AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular Disease (TRANSCEND) cardiovascular (CV) outcomes, although no reduction in new-onset AF was found. [25][26][27] The purpose of the present study was to assess the efficacy of an antihypertensive therapeutic dose of telmisartan (80 mg once daily) as compared with that of the β-blocker carvedilol (25 mg once daily), which has been shown to have clinically important anti-arrhythmic properties, [28][29][30][31][32] for the prevention of AF recurrence in a population of hypertensive patients with a recent history of AF and who were in sinus rhythm and who did not require anti-arrhythmic therapy.…”

Changes of Gene Expressions in Spontaneously Hypertensive Rat Model After Losartan Treatment

“…Losartan is a highly specific, non-peptide antagonist of the AT II receptor type 1 4). AT II receptor antagonists are a group of drugs that are used in the treatment of hypertension.…”