Comparison of the efficacy and tolerability of telmisartan 40 mg vs. enalapril 10 mg in the treatment of mild-to-moderate hypertension: a multicentre, double-blind study in Taiwanese patients

Chen, Jyh-Hong; Cheng, Jian; Chen, Chiung-Yu; Chiou, Herng Cheng; Huang, Tsuei Yuen; Tsai, Cheng-Dao; Fu, Morgan; Cherng, Wen Jin

doi:10.1111/j.1742-1241.2004.00407.x

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…In clinical studies of telmisartan monotherapy, mean placebo-corrected SBP and DBP reductions were 10 to 17 mm Hg and 7 to 11 mm Hg, respectively, at the 40-mg dose, and 12 to 17 mm Hg and 8 to 11 mm Hg, respectively, at the 80-mg dose. [22][23][24][25][26][27][28] In clinical studies of amlodipine, mean placebo-corrected SBP and DBP reductions were 11 to 13 mm Hg and 7 to 10 mm Hg, respectively. [29][30][31][32] With respect to secondary endpoints, the proportion of patients achieving DBP and SBP response, BP control, and DBP control with various telmisartan plus amlodipine combinations are shown in Table 1.…”

Section: Effi Cacy Of Single-dose Telmisartan Plus Amlodipinementioning

confidence: 99%

Review: A Single-Pill Combination of Telmisartan plus Amlodipine for the Treatment of Hypertension

Guthrie

2011

Postgraduate Medicine

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Despite an increased proportion of patients with hypertension achieving recommended blood pressure (BP) targets, BP control remains suboptimal in many patients. A range of combination therapies utilizing medications with differing mechanisms of action have been shown to provide superior BP-lowering efficacy than monotherapy with individual components. Single-pill combinations deliver improved convenience and may help to improve patient compliance. A single-pill combination of the angiotensin receptor blocker (ARB) telmisartan and the calcium channel blocker (CCB) amlodipine has recently been approved in 4 different doses (telmisartan/amlodipine 40 mg/5 mg, 40 mg/10 mg, 80 mg/5 mg, and 80 mg/10 mg) for antihypertensive use in the United States. In an 8-week clinical study (N = 1461), these combinations were superior to monotherapy with telmisartan or with amlodipine with respect to the primary endpoint, change in diastolic BP (DBP) from baseline (mean baseline BP, 153.2 [± 12.1]/101.7 [± 4.3] mm Hg) to study end (placebo-corrected reductions of 10.3, 14.0, 12.0, and 13.9 mm Hg, respectively), as well as in multiple secondary endpoints, including change in systolic BP (SBP), DBP response, SBP response, BP control (< 140/< 90 mm Hg), and DBP control (< 90 mm Hg). The telmisartan plus amlodipine combinations were well tolerated, with the incidence of adverse events similar to placebo; the incidence of peripheral edema was lower with the 40 mg/10 mg and 80 mg/10 mg combinations than with amlodipine 10 mg alone. In another study (N = 858), the highest-dose combination (80 mg/10 mg) demonstrated superior BP-lowering efficacy than same-dose monotherapy with either telmisartan or amlodipine in patients with severe hypertension (SBP ≥ 180 and DBP ≥ 95 mm Hg). Single-pill telmisartan plus amlodipine combination therapy appears to be an effective and well-tolerated treatment as initial therapy for patients likely to require > 1 antihypertensive agent to reach BP targets.

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Section: Effi Cacy Of Single-dose Telmisartan Plus Amlodipinementioning

confidence: 99%

Review: A Single-Pill Combination of Telmisartan plus Amlodipine for the Treatment of Hypertension

Guthrie

2011

Postgraduate Medicine

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“…15 Telmisartan versus enalapril Thirteen trials involving 1682 patients compared telmisartan with enalapril. 5,[15][16][17][18][19][20][21][22][23][24][25][26] There was a greater reduction in both DBP and SBP with the use of telmisartan as compared with enalapril. Therapeutic response rates of DBP and SBP favored telmisartan (RR 1.15, 95% confidence interval (CI) 1.05-1.26; RR 1.18, 95% CI 1.02-1.38, respectively).…”

Section: Resultsmentioning

confidence: 99%

Telmisartan versus angiotension-converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials

Zou

Yuan

et al. 2008

J Hum Hypertens

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Telmisartan and angiotensin-converting enzyme inhibitors (ACEIs) are both effective and widely used antihypertensive drugs targeting renin-angiotensinaldosterone system. The study aimed to estimate the efficacy and tolerability of telmisartan in comparison with different ACEIs as monotherapy in the treatment of hypertension. Cochrane Central Register of Controlled Trials, PubMed and Embase were searched for relevant studies. A meta-analysis of all randomized controlled trials fulfilling the predefined criteria was performed. A random-effect model was used to account for heterogeneity among trials. Twenty-eight randomized controlled trials involving 5157 patients were ultimately identified out of 721 studies. Telmisartan had a greater diastolic blood pressure (DBP) reduction than enalapril (weighted mean difference (WMD) 1.82, 95% confidence interval (CI) 0.66-2.99), ramipril (WMD 3.09, 95% CI 1.94-4.25) and perindopril (WMD 1.48, 95% CI 0.33-2.62). Telmisartan also showed a greater DBP response rate than enalapril (relative risk (RR) 1.15, 95% CI 1.05-1.26), ramipril (RR 1.34, 95% CI 1.11-1.61) and perindopril (RR 1.22, 95% CI 1.05-1.41). There was no statistical difference in DBP reduction or therapeutic response rate between telmisartan and lisinopril (WMD À0.30, 95% CI À0.65 to 0.05; RR 0.99, 95% CI 0.80-1.23, respectively). Telmisartan had fewer drug-related adverse events than enalapril (RR 0.57, 95% CI 0.44-0.74), ramipril (RR 0.44, 95% CI 0.26-0.75), lisinopril (RR 0.70, 95% CI 0.56-0.89) and perindopril (RR 0.52, 95% CI 0.28-0.98). The meta-analysis indicates that telmisartan provides a superior BP control to ACEIs (enalapril, ramipril and perindopril) and has fewer drug-related adverse events and better tolerability in hypertensive patients.

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“…In a randomized, double-blind, double-dummy, parallel group study,[5] telmisartan 40 mg produced a significantly greater reduction from baseline diastolic BP compared with enalapril 10 mg (11.7 versus 8.7 mmHg, respectively; P = 0.02). In another comparative multicentric trial[6] between telmisartan 80 mg and enalapril 20 mg, the mean reduction in systolic and diastolic BP were significantly higher with telmisartan as compared with enalapril (systolic BP, P = 0.013; diastolic BP, P = 0.002).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy and tolerability of telmisartan and enalapril in patients of mild to moderate essential hypertension

et al. 2010

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Background:Theoretically, angiotensin II receptor blockers (ARBs) have certain advantages over angiotensin-converting enzyme inhibitors, but the contribution of these advantages to the clinical effect of ARBs is not known.Objective:To compare the efficacy and tolerability of telmisartan with enalapril in patients of essential hypertension.Materials and Methods:Patients of mild to moderate hypertension were randomized to receive either 40 mg of telmisartan or enalapril 10 mg once a day orally for 12 weeks. At each visit, the systolic blood pressure (BP), diastolic BP and heart rate of each patient were recorded. Investigations such as hemogram hemoglobin, total leucocytes count (Hb, TLC), serum creatinine, serum glutamic oxaloacetic transaminase, serum glutamic pyruric transaminase (SGOT, SGPT) random blood sugar and urine examination were performed at baseline and after 12 weeks of the treatment period.Results:The mean reduction in systolic BP in the telmisartan/enalapril group was 26.38 ± 10.98/26.74 ± 8.24 mmHg while the mean reduction in diastolic BP in the telmisartan/enalapril group was 14 ± 2.98/9.71 ± 4.23 mmHg, respectively, at 12 weeks. When the reduction in systolic BP in the two groups was compared, there was no significant difference between the groups (P > 0.05). However, the mean reduction in diastolic BP achieved with telmisartan at 12 weeks was significantly higher (P < 0.001) than that achieved with enalapril after the corresponding period. The overall frequency of adverse-effects was similar. However, in the enalapril group, the incidence of dry cough was higher as compared to that in the telmisartan group (11.43% vs. 0%, respectively; P < 0.05).Conclusion:Telmisartan produces a greater reduction in diastolic BP than enalapril and is free from the adverse-effect of dry cough that is commonly encountered with enalapril.

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Comparison of the efficacy and tolerability of telmisartan 40 mg vs. enalapril 10 mg in the treatment of mild-to-moderate hypertension: a multicentre, double-blind study in Taiwanese patients

Cited by 11 publications

References 24 publications

Review: A Single-Pill Combination of Telmisartan plus Amlodipine for the Treatment of Hypertension

Review: A Single-Pill Combination of Telmisartan plus Amlodipine for the Treatment of Hypertension

Telmisartan versus angiotension-converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials

Comparison of the efficacy and tolerability of telmisartan and enalapril in patients of mild to moderate essential hypertension

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