Arms and Interventions. Outcome Measures. Primary Outcome Measures : Change from baseline in mean diastolic blood pressure [ Time Frame: Up to 8 weeks after start of treatment ] Measured during the last 6 hours of the hour dosing interval using ABPM. Secondary Outcome Measures : Change from baseline in mean systolic blood pressure [ Time Frame: Up to 8 weeks after start of treatment ] Measured during the last 6 hours of the hour dosing interval using ABPM.
Measured during other times of the hour ABPM profile e. Triplicate measurement in two minute intervals after 5 minutes of rest, in seated position using sphygmomanometer. Eligibility Criteria. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Contacts and Locations. In addition, the reduction in mean h ambulatory DBP among patients receiving telmisartan was only 1. The exact definition of a clinically relevant difference in blood pressure in the general population is clearly open to debate.
The objective of antihypertensive treatment, however, should be to achieve blood pressure control as stipulated in management guidelines. However, in the overall HOT population, no differences were observed in cardiovascular event or mortality rates among the three target groups whose DBP was lowered by Various outcomes studies over the past few years have shown that SBP is a powerful predictor of pending cardiovascular disease, 15 such that even small SBP reductions can produce an important clinical impact in specific patient populations.
Consequently, there is now increased emphasis on lowering of pulse pressure, especially among the elderly. When the current study was designed January , systolic noninferiority was not included as a primary end point which, in retrospect, was unfortunate.
However, the present study did not specifically include elderly patients or those at high risk of cardiovascular events. Therefore, further studies are required. In this study, telmisartan, a newly available angiotensin receptor antagonist, produced reductions in mean h DBP which were, according to the protocol definition, not inferior to those produced by a low-dose combination agent losartan plus HCTZ. The findings in the current study may be related to the fact that telmisartan is a long-acting drug that binds tightly to AT 1 receptors.
It is crucial in the management of hypertension to use agents that are administered on a once-daily basis. Compliance rates have been shown to be greater in patients treated with once-daily agents compared with those treated with drugs that require more frequent dosing.
It is, however, essential to select once-daily drugs that provide effective control over the entire h period. The reductions in blood pressure during the morning period were similar to the mean h blood pressure reduction, suggesting a smooth decrease in blood pressure that was maintained throughout the dosing interval.
There were no differences between the side effect profiles of the drugs. It is now well accepted that angiotensin receptor blockers are extraordinarily well-tolerated drugs, and it is interesting to note that the addition of a small dose of HCTZ to losartan did not have a negative impact on its side-effect profile.
This demonstrates one of the benefits of low-dose combination therapy: it provides effective blood pressure control with fewer dose-dependent side effects because of the ability to achieve adequate blood pressure control with smaller doses of the component agent HCTZ dosed at In a follow-up study with patients of the present study, addition of HCTZ In addition, both treatments were extremely well tolerated.
Safety, efficacy and duration of action are critical factors required to achieve adequate blood pressure control. Thus, telmisartan, a newer angiotensin receptor blocker, is a very useful addition to our armamentarium for the management of patients with mild-to-moderate hypertension and an important alternative as first-line treatment of this disease.
Hansson L et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment HOT randomised trial. Lancet ; : — Arch Intern Med ; : — Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS BMJ ; : — Article Google Scholar. Burt VL et al. Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population.
Data from the Health Examination Surveys, to Hypertension ; 26 : 60— Marques-Vidal P, Tuomilehto J. J Hum Hypertens ; 11 : — Familial aspects of the hypertension syndrome. J Cardiovasc Risk ; 4 : — Neutel JM et al. Telmisartan-induced reductions were also greater for the majority of the observed hourly mean ambulatory DBP values over the entire h dosing interval.
Reductions from baseline in the last 6 h adjusted mean ambulatory systolic blood pressure SBP for telmisartan and losartan were 9. Am J Cardiol. Mancia G, Parati G: Importance of smooth and sustained blood pressure control in preventing cardiovascular morbidity and mortality.
Blood Press Suppl. PubMed Google Scholar. Am Heart J. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Giuseppe MC Rosano. All authors contributed to the conduct of the study.
GR conceived the study and prepared the manuscript. Reprints and Permissions. Vitale, C. Metabolic effect of telmisartan and losartan in hypertensive patients with metabolic syndrome. Cardiovasc Diabetol 4, 6 Download citation. Received : 10 March Accepted : 15 May Published : 15 May Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Metabolic syndrome is a cluster of common cardiovascular risk factors that includes hypertension and insulin resistance. Background Metabolic syndrome describes the presence of a cluster of common cardiovascular risk factors, including hypertension, insulin resistance or glucose intolerance, visceral obesity, atherogenic dyslipidemia, prothrombotic state and proinflammatory state in a single individual [ 1 , 2 ].
Materials and methods The study population included men and women aged between 18 and 75 years with arterial hypertension and the diagnosis of metabolic syndrome. Results A total of 40 patients were enrolled, with 20 randomized to each treatment group, baseline clinical characteristics of study patients are shown in table 1 , no significant differences were noted between groups.
Table 1 Patient baseline characteristics Full size table. Figure 1. Full size image. Figure 2. Figure 3.
Effect of telmisartan and losartan on the smoothness index at endpoint. Discussion This study found that, compared with once-daily losartan 50 mg, once-daily telmisartan 80 mg reduced hour mean blood pressure and blood pressure variability, and improved glucose tolerance and insulin sensitivity. Conclusion This study found that telmisartan, but not losartan, improves metabolic parameters in patients with metabolic syndrome. References 1. Article PubMed Google Scholar 5.
Article PubMed Google Scholar 8.
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