Freehand three-dimensional echocardiographic evaluation of the effect of telmisartan compared with hydrochlorothiazide on left ventricular mass in hypertensive patients with mild-to-moderate hypertension: a multicentre study

Abstract

Antihypertensive efficacy, effects on left ventricular mass index (LVMI) and tolerability of telmisartan, an angiotensin II receptor blocker, were compared with those of hydrochlorothiazide (HCTZ). Adult patients with mild-to-moderate hypertension and an optimal acoustic window by two-dimensional echocardiography were randomised at baseline to 12 months' double-blind, once-daily treatment with telmisartan 80 mg or HCTZ 25 mg. Two-dimensional echocardiography and freehand precordial three-dimensional echocardiography and 24-h ambulatory blood pressure monitoring were performed at baseline and after treatment. Of the 41 telmisartan group patients and 28 HCTZ group patients, 40 and 25, respectively, completed the study. Following treatment, 24-h mean SBP (telmisartan 157 7 11 vs 133 7 7 mmHg, Po0.001; HCTZ 154 7 10 vs 144 7 11 mmHg, Po0.003) and DBP (telmisartan 96 7 6 vs 83 7 5 mmHg, Po0.001; HCTZ 95 7 7 vs 87 7 8 mmHg, Po0.003) were significantly reduced. Telmisartan produced significantly greater 24-h mean SBP and DBP reductions than HCTZ (Po0.001). LVMI was significantly reduced by telmisartan (141 7 16 vs 125 7 19 g/m 2 , Po0.001), but not by HCTZ (139 7 20 vs 135 7 22 g/m 2 ). Incidences of adverse events in both the treatment groups were low; two cases of hypokalaemia occurred with HCTZ. In conclusion, telmisartan 80 mg was well tolerated and significantly reduced SBP, DBP and LVMI after 12 months' treatment compared with HCTZ.

New standards in hypertension and cardiovascular risk management: focus on telmisartan

“…Telmisartan has been compared with other antihypertensives, including diuretics, β-blockers, ACE inhibitors, and other ARBs. Telmisartan 80 mg proved superior to HCTZ 25 mg, with the reduction in LVM being significantly greater with telmisartan for a given percentage change in blood pressure 57. Telmisartan 80 mg was more effective in reducing LVM than carvedilol 25 mg, despite there being no significant difference in 24-hour mean SBP/DBP reductions between the two treatments 53.…”

“…In a 12-month study to determine the effect of telmisartan and HCTZ on LVH in hypertensive patients, 24-hour ABPM was performed at baseline and after 12 months’ double-blind treatment with telmisartan 80 mg or HCTZ 25 mg 57. At the end of the study, significant reductions from baseline in 24-hour mean SBP/DBP were detected in both treatment groups, but the blood pressure-lowering effect of 24/13 mmHg with telmisartan versus 10/8 mmHg with HCTZ was significantly superior ( P < 0.01).…”

A multicentre, randomized study of telmisartan versus carvedilol for prevention of atrial fibrillation recurrence in hypertensive patients

“…those who have not had any previous episodes of AF, and those with paroxysmal or persistent AF who either do not need any antiarrhythmic therapy, or those with persistent AF who do require anti-arrhythmic therapy to maintain sinus rhythm following cardioversion). [16][17][18][19] Telmisartan has the longest half-life of any ARB (approximately 24 hours) 20 and has been shown to reduce left ventricular hypertrophy (LVH) in clinical studies of hypertensive patients, [21][22][23][24] as well as in the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and Telmisartan Randomized AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular Disease (TRANSCEND) cardiovascular (CV) outcomes, although no reduction in new-onset AF was found. [25][26][27] The purpose of the present study was to assess the efficacy of an antihypertensive therapeutic dose of telmisartan (80 mg once daily) as compared with that of the β-blocker carvedilol (25 mg once daily), which has been shown to have clinically important anti-arrhythmic properties, [28][29][30][31][32] for the prevention of AF recurrence in a population of hypertensive patients with a recent history of AF and who were in sinus rhythm and who did not require anti-arrhythmic therapy.…”

Regressing Left Ventricular Hypertrophy: The Role of Telmisartan and Other ARBs

“…Using three-dimensional echocardiography, we gave hypertensive patients with or without LVH either telmisartan 80 mg (n=48) or HCTZ 25 mg (n=21) for 12 months [48]. Telmisartan significantly reduced LVM compared with HCTZ (Fig.…”