Effects of the Angiotensin II Receptor Blockers Telmisartan vs Valsartan in Combination With Hydrochlorothiazide 25 mg Once Daily for the Treatment of Hypertension

Abstract

3,4 While several drug classes effectively treat hypertension, there has been a growing trend toward the use of angiotensin receptor blockers (ARBs), alone or in fixed combination with

Impact of angiotensin receptor blockade in combination with hydrochlorothiazide 25 mg in 2121 patients with stage 1–2 hypertension

“…The results of our analysis can be explained in part by the pharmacokinetic profile of telmisartan, which is characterized by a longer half-life than valsartan, 9,12 and by earlier pharmacodynamic studies using ambulatory BP monitoring that showed greater BP reductions on telmisartan compared with valsartan without the diuretic component. [16][17][18] This study also confirms and extends what had been shown regarding the combination therapies for the angiotensin II receptor blockers that use a higher dose of HCTZ (25 mg), 13,14 an option that has been shown to be increasingly useful in management of clinical hypertension. 3,12 Effects of angiotensin receptor blockers in combination with HCTZ A number of fixed-dose combination therapies of angiotensin receptor blocking agents and diuretics are currently available for the treatment of hypertension.…”

“…These results are quite similar to those of the present trial (Table 2), in which valsartan-HCTZ 160/25 lowered the BP by 22/17 mm Hg. In fact, the BP reductions in the two trials 13,14 were strikingly similar to each other. The baseline BP levels in both treatment groups and demographics of the study population for the two studies were also quite similar.…”

“…13,24 Age, gender and race did not play a substantial role in the differential effects between telmisartan-HCTZ 80/25 and valsartan-HCTZ 160/25. The antihypertensive efficacy differences between telmisartan-HCTZ and valsartan-HCTZ, although small, bear clinical significance.…”

“…12 In the present analysis, we have evaluated the antihypertensive effects of fixed-dose combinations of the angiotensin receptor blockers telmisartan and valsartan with 25-mg of HCTZ to determine the benefits and tolerability of these increasingly used therapies. As two independent and identically designed trials were completed with these antihypertensive combination strategies 13,14 we were able to pool the efficacy and safety data from the two trials. This process yielded a substantial sample size of over 2000 patients and had the advantage of greatly increasing the statistical power to examine the antihypertensive efficacy of telmisartan and valsartan with HCTZ.…”

Where Does the Evidence Lead Us for the Proper Use of Angiotensin II Inhibitors in the Management of Cardiovascular Disease

“…A series of comparison trials between different ARB agents have shown that there are differences in the degree of blood pressure lowering between agents in the ARB class [3][4][5][6][7] . Essentially, newer ARB agents were developed to increase binding at the AT-1 receptor binding site, producing enhanced blood pressure lowering.…”