Efficacy and safety of telmisartan vs. losartan in control of mild-to-moderate hypertension: a multicentre, randomised, double-blind study

Abstract

This multicentre, randomised, double-blind, doubledummy, parallel-group study compared the efficacy and safety of telmisartan with those of losartan after 8 weeks' treatment. In total, 330 patients with mild-tomoderate hypertension (systolic blood pressure [SBP] <180 mmHg; diastolic blood pressure [DBP] 95-109 mmHg) were randomly assigned to receive oncedaily treatment with telmisartan 40 mg (n ¼ 164) or losartan 50 mg (n ¼ 166). After 4 weeks' treatment, if a patient's DBP was ‡90 mmHg, the dose was increased to telmisartan 80 mg or losartan 100 mg, respectively. The results show that mean trough seated blood pressure was reduced significantly more in the telmisartan group than that in the losartan group (SBP 12.5 mmHg vs. 9.4 mmHg, p ¼ 0.037; DBP 10.9 mmHg vs. 9.3 mmHg, p ¼ 0.030). The overall DBP response rate (reduction from baseline in mean seated DBP ‡ 10 mmHg and ⁄ or a mean seated DBP <90 mmHg) at the end of the study in the telmisartan group was higher than that in losartan group (70.1% vs. 58.7%, p ¼ 0.020). At both the low and high doses, the DBP response rates for telmisartan were significantly higher than those for losartan (telmisartan 40 mg vs. losartan 50 mg: 46.3% vs. 32.5%, p ¼ 0.010; telmisartan 80 mg vs. losartan 100 mg: 79.3% vs. 65.3%, p ¼ 0.008). Adverse events with the two treatments were comparable (telmisartan vs. losartan 23.2% vs. 22.9%, p ¼ 0.952). Most events were mild in intensity and abated within 72 h. Thus, telmisartan 40 mg or 80 mg administered once daily can reduce SBP and DBP effectively and safely.

Meta-analysis of Randomized Controlled Trials Comparing Telmisartan With Losartan in the Treatment of Patients With Hypertension

“…A total of 11 randomized controlled trials met the criteria for inclusion in this meta-analysis. [13][14][15][16][17][18][19][20][21][22][23] The flow of the studies included in our analysis is shown in Figure 1. In one trial, 13 in which patients were randomized to receive telmisartan 40 mg, telmisartan 80 mg, losartan 50 mg, or placebo, we did not extract the data of telmisartan 80 mg group so as to avoid potential duplication.…”

Comparison of efficacy of telmisartan with losartan in patients of essential hypertension with cognitive impairment

“…Zhu JR et al and Mallion J et al showed that telmisartan was more effective than losartan in hypertensive patients. 13,14 Mini mental status examination test and trail making test part-A are standard test for evaluation of cognitive impairment. An increase in the MMSE score and reduction in TMT part-A score are used as marker of improvement in cognitive function.…”

Telmisartan Improves Endothelial Function in Patients With Essential Hypertension

“…[12][13][14] The efficacy of telmisartan has been shown to be at least equivalent to that of many other commonly prescribed antihypertensive agents (eg, losartan, enalapril, and amlodipine). [15][16][17][18] Data regarding the influence of telmisartan on endothelial function and RVRI in patients with essential hypertension remain scarce. Therefore the aim of this study was to examine whether telmisartan, the calcium channel blocker nisoldipine, or the combination of both drugs improves endothelial function and renal vascular resistance in patients with essential hypertension.…”