Angiotensinconvertingenzyme(ACE) inhibitorsaremost commonly prescribed therapy for initial management of hypertension, but ARBs have now gained preference over ACE inhibitors due to their harmful effects which lead to increased withdrawal rates.12 Telmisartan is an ARB, most widely used antihypertensive agent among other drugs of its class.13 It is highly effective for the management of hypertension. To determine its efficacy, a multicentered, placebo-controlled clinical study14 was conducted in patients with mild-to-moderate hypertension. The results divulged that telmisartan at a dose of 20 to 160 mg once daily significantly reduced supine trough SBP and DBP up to 15.5 and 10.5 mmHg, respectively. The maximum BP reduction occurred with a dosage of 40 to 80 mg/day. Moreover, a dose of 80 mg/day was more effective than sub-maximal dosages of placebo. The researchers therefore concluded that telmisartan is an effective antihypertensive agent and has a better tolerability profile with minimal side effects compared to placebo. These results were in line with another placebo controlled study15 which compared telmisartan doses of 20, 40, 80 mg with placebo. The results concluded that all doses of telmisartan (20-80 mg) were considerably superior to placebo.

Telmisartan is additionally found to be more efficacious and safer than losartan (another ARB). This was validated by a multicenter randomized parallel- group study16 which compared the efficacy and safety of telmisartan with losartan. A total of 330 patients with mild-to-moderate hypertension (SBP <180 mmHg and DBP=95-109 mmHg) were randomized to receive once-daily treatment either with telmisartan 80 mg or losartan 100 mg. The results revealed that there was more significant reduction in mean trough seated blood pressure with telmisartan group than with losartan group (SBP: 12.5 mmHg versus 9.4 mmHg; DBP: 10.9 mmHg versus 9.3 mmHg). The overall success rate with telmisartan was 79.3% compared to 65.3% with losartan (figure 2). Similar results were shown in another multicentered study17 which compared the efficacy of telmisartan with an ACE inhibitor, enalapril. The results showed that the mean reduction in supine trough DBP was 12.5 mmHg for telmisartan, compared with 11.9 mmHg for enalapril. The clinical success rates were 78% and 65% with telmisartan and enalapril, respectively.

An appraisal of the aforementioned data suggests that telmisartan is indeed a potent agent for the management of hypertension.

Conclusion

Hypertension is a cardiovascular disorder with complex etiologies. It is the most common risk factor for developing CVD, thereby posing a huge burden on the society. Telmisartan is an angiotensin II receptor antagonist, which is proved to be an effective agent for the appropriate management of hypertension. Several studies have provided evidence in support of its efficacy and safety in hypertensive patients.

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