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Telmisartan for the management of patients at high cardiovascular risk.
Curr Med Res Opin 2011; 27(8):1673-82CM

Abstract

BACKGROUND

Cardiovascular disease (CVD) places a significant burden on healthcare providers. High blood pressure (BP) is the single most prevalent risk factor for CVD worldwide and is responsible for more deaths than any other risk factor. 'Cardiovascular (CV) high-risk patients' make up the broad cross-section of patients in the middle of the risk spectrum for CVD progression that is referred to as the CV continuum and includes those with atherothrombotic disease, those with target organ damage associated with type 2 diabetes and those with multiple risk factors. Angiotensin II is involved in CVD progression at every stage of the CV continuum, making the renin-angiotensin system a rational target for pharmacologic intervention. Angiotensin II receptor blockers (ARBs) offer a better tolerated alternative to angiotensin converting enzyme inhibitors, with greater long-term adherence. The ARB telmisartan recently received an indication for CV prevention.

SCOPE

A PubMed literature search was conducted to identify evidence on the use of telmisartan for preventing CV events.

FINDINGS

Telmisartan has a favourable safety and tolerability profile, and has demonstrated efficacious and long-lasting 24-hour BP reductions, whether as monotherapy or in combination with hydrochlorothiazide or amlodipine. In the largest CV prevention trial program undertaken with an ARB (the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial; ONTARGET), telmisartan 80 mg/day alone was as effective as ramipril in reducing the composite primary endpoint of CV mortality, non-fatal myocardial infarction, non-fatal stroke and hospitalization for heart failure in CV high-risk patients. However, patients were significantly more likely to adhere to treatment with telmisartan than ramipril due to its better tolerability.

CONCLUSION

To date, telmisartan is the only ARB indicated to reduce CV morbidity in a broad CV high-risk population.

Authors+Show Affiliations

Servicio de Nefrologia, Unidad de Hipertension, Hospital 12 de Octubre, Madrid, Spain. ruilope@ad-hocbox.com

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

21718097

Citation

Ruilope, Luis M.. "Telmisartan for the Management of Patients at High Cardiovascular Risk." Current Medical Research and Opinion, vol. 27, no. 8, 2011, pp. 1673-82.
Ruilope LM. Telmisartan for the management of patients at high cardiovascular risk. Curr Med Res Opin. 2011;27(8):1673-82.
Ruilope, L. M. (2011). Telmisartan for the management of patients at high cardiovascular risk. Current Medical Research and Opinion, 27(8), pp. 1673-82. doi:10.1185/03007995.2011.597378.
Ruilope LM. Telmisartan for the Management of Patients at High Cardiovascular Risk. Curr Med Res Opin. 2011;27(8):1673-82. PubMed PMID: 21718097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Telmisartan for the management of patients at high cardiovascular risk. A1 - Ruilope,Luis M, Y1 - 2011/06/30/ PY - 2011/7/2/entrez PY - 2011/7/2/pubmed PY - 2011/11/16/medline SP - 1673 EP - 82 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 27 IS - 8 N2 - BACKGROUND: Cardiovascular disease (CVD) places a significant burden on healthcare providers. High blood pressure (BP) is the single most prevalent risk factor for CVD worldwide and is responsible for more deaths than any other risk factor. 'Cardiovascular (CV) high-risk patients' make up the broad cross-section of patients in the middle of the risk spectrum for CVD progression that is referred to as the CV continuum and includes those with atherothrombotic disease, those with target organ damage associated with type 2 diabetes and those with multiple risk factors. Angiotensin II is involved in CVD progression at every stage of the CV continuum, making the renin-angiotensin system a rational target for pharmacologic intervention. Angiotensin II receptor blockers (ARBs) offer a better tolerated alternative to angiotensin converting enzyme inhibitors, with greater long-term adherence. The ARB telmisartan recently received an indication for CV prevention. SCOPE: A PubMed literature search was conducted to identify evidence on the use of telmisartan for preventing CV events. FINDINGS: Telmisartan has a favourable safety and tolerability profile, and has demonstrated efficacious and long-lasting 24-hour BP reductions, whether as monotherapy or in combination with hydrochlorothiazide or amlodipine. In the largest CV prevention trial program undertaken with an ARB (the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial; ONTARGET), telmisartan 80 mg/day alone was as effective as ramipril in reducing the composite primary endpoint of CV mortality, non-fatal myocardial infarction, non-fatal stroke and hospitalization for heart failure in CV high-risk patients. However, patients were significantly more likely to adhere to treatment with telmisartan than ramipril due to its better tolerability. CONCLUSION: To date, telmisartan is the only ARB indicated to reduce CV morbidity in a broad CV high-risk population. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/21718097/Telmisartan_for_the_management_of_patients_at_high_cardiovascular_risk_ L2 - http://www.tandfonline.com/doi/full/10.1185/03007995.2011.597378 DB - PRIME DP - Unbound Medicine ER -