Safety of Telmisartan in Patients with Arterial Hypertension

Michel, Martin C.; Bohner, Herbert; Köster, Jürgen; Schäfers, Rainhild; Heemann, Uwe

doi:10.2165/00002018-200427050-00005

Cited by 58 publications

(34 citation statements)

References 28 publications

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“…17,18 This applies also to the high tolerability and low incidence of side effects seen in our study. The observed inverse relation between treatment effect and number of previous BP drugs used is not surprising, as many patients with BP polypharmacy in fact do have a refractory hypertension which also could apply to telmisartan.…”

Section: Discussionsupporting

confidence: 63%

Effects of telmisartan on office and 24-hour ambulatory blood pressure: an observational study in hypertensive patients managed in primary care

Johansen¹,

Kontny²,

Risanger³

et al. 2010

VHRM

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Purpose: Although elevated blood pressure (BP) predicts future cardiovascular events, recommended BP targets often is not reached in the general community. In a clinical real-life setting we evaluated BP impact and tolerability of the angiotensin-II receptor blocker telmisartan in patients with essential hypertension. Patients and methods: Patients in this observational study not at target BP started or switched to telmisartan monotherapy (40 or 80 mg) or a fixed-dose combination of telmisartan and hydrochlorothiazide (HCT) 80 mg/12.5 mg. Office and 24-hour ambulatory BP (AMBP) were measured before and after 8 weeks of treatment and physicians reported perceived drug efficacy and tolerability as "Very good", "Good", "Moderate" or "Bad". Results: 100 patients (34% female, 60 years, BMI 29.4 kg/m 2 , mean office BP 159/92 mmHg) of whom 38% were treatment naïve and 30%, 17%, 9% and 6% respectively were on 1, 2, 3 or 4 BP-lowering drugs, completed 8 weeks of treatment. The proportion of patients with office BP  140/90 mmHg increased from 3% to 54% for systolic (P  0.001), 38% to 75% for diastolic (P  0.001), and 2% to 45% for systolic and diastolic BP (P  0.001). A significant effect on BP levels was seen in patients being either treatment naïve or on 1 to 3 BP-lowering drugs at study entry, whereas no BP improvement occurred in those who switched from 4 drugs. Overall, mean 24-hour AMBP was reduced from 141/85 to 131/79 mmHg (P  0.001). Drug efficacy and tolerability were perceived as "Very good" or "Good" by 44%/34% and 66%/27%, respectively. No drug discontinuations or serious adverse events were observed. Conclusions: In this observational study, telmisartan 40 to 80 mg, or the fixed-dose combination telmisartan 80 mg/HCT 12.5 mg, significantly increased the number of patients reaching target BP  140/90 mmHg if treatment naïve or previously receiving 1 to 3 BP-lowering drugs. The BP reduction achieved was sustained for 24-hour and treatment tolerability was high.

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Section: Discussionsupporting

confidence: 63%

Effects of telmisartan on office and 24-hour ambulatory blood pressure: an observational study in hypertensive patients managed in primary care

Johansen¹,

Kontny²,

Risanger³

et al. 2010

VHRM

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“…As the general linear model approach used reduction in symptom intensity after intake of medication as dependent variable, this is not surprising as subjects with a high baseline value can reduce absolute symptom intensity to a greater extent. This phenomenon has also been observed in the analysis of databases from observational treatment studies in other indications, for instance arterial hypertension23 or overactive bladder syndrome 24…”

Section: Discussionmentioning

confidence: 53%

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms

Klimek

Schumacher²,

Schütt

et al. 2016

Int J Clin Pract

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SummaryAimThe aim of this study was to explore factors affecting efficacy of treatment of common cold symptoms with an over‐the‐counter ibuprofen/pseudoephedrine combination product.MethodsData from an anonymous survey among 1770 pharmacy customers purchasing the combination product for treatment of own common cold symptoms underwent post‐hoc descriptive analysis. Scores of symptoms typically responsive to ibuprofen (headache, pharyngeal pain, joint pain and fever), typically responsive to pseudoephedrine (congested nose, congested sinus and runny nose), considered non‐specific (sneezing, fatigue, dry cough, cough with expectoration) and comprising all 11 symptoms were analysed. Multiple regression analysis was applied to explore factors associated with greater reduction in symptom intensity or greater probability of experiencing a symptom reduction of at least 50%.ResultsAfter intake of first dose of medication, typically ibuprofen‐sensitive, pseudoephedrine‐responsive, non‐specific and total symptoms were reduced by 60.0%, 46.3%, 45.4% and 52.8%, respectively. A symptom reduction of at least 50% was reported by 73.6%, 55.1%, 50.9% and 61.6% of participants, respectively. A high baseline score was associated with greater reductions in symptom scores but smaller probability of achieving an improvement of at least 50%. Across both multiple regression approaches, two tablets at first dosing were more effective than one and (except for ibuprofen‐sensitive symptoms) starting treatment later than day 2 of the cold was generally less effective.Discussion and ConclusionsEfficacy of an ibuprofen/pseudoephedrine combination in the treatment of common cold symptoms was dose‐dependent and greatest when treatment started within the first 2 days after onset of symptoms.

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“…80,82 with fluid retention and weight gain. 95 The differences in adverse-effect profiles between selective PPAR␥ modulators like telmisartan and conventional PPAR␥ agonists like the thiazolidinediones could be related to the fact that SPPARMs do not stimulate PPAR␥ as much as the glitazones and also have more selective effects on the recruitment of key transcription cofactors that influence PPAR␥ target gene expression profiles. 85,96 Molecular modeling studies have suggested that telmisartan may interact with the ligand-binding domain of PPAR␥ differently than the glitazones, thereby resulting in different conformational changes in the receptor.…”

Section: Implications For Treatment Of the Metabolic Syndromementioning

confidence: 99%

Molecular Genetics of Experimental Hypertension and the Metabolic Syndrome

Pravenec

Kurtz²

2007

Hypertension

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Abstract-Genetic studies of human and experimental hypertension provide a means to identify key pathways that predispose individuals to increased blood pressure and associated risk factors for cardiovascular and metabolic diseases. The pathways so identified can then serve as targets for therapeutic intervention. This article discusses genetic studies in animal models of hypertension in which specific genes have been identified that regulate blood pressure and biochemical features of the metabolic syndrome. Consistent with studies in humans with monogenic disorders of blood pressure regulation, studies in rat models have demonstrated that naturally occurring genetic variation in pathways regulating sodium chloride transport can contribute to inherited variation in blood pressure. Such studies have also indicated that naturally occurring variation in genes, such as Cd36, that regulate fatty acid metabolism and ectopic accumulation of fat and fat metabolites can influence both biochemical and hemodynamic features of the metabolic syndrome and mediate the antidiabetic effects of drugs that activate the peroxisome proliferator-activated receptor-␥. Angiotensin II receptor blockers with the ability to selectively modulate activity of peroxisome proliferator-activated receptor-␥ and expression of genes in these fat metabolism pathways may represent useful prototypes for a new class of transcription modulating drugs aimed at treating patients with hypertension and the metabolic syndrome. Key Words: genetics Ⅲ rats Ⅲ inbred SHR Ⅲ metabolic syndrome X Ⅲ hypertension Ⅲ angiotensin II type 1 receptor blockers Ⅲ peroxisome proliferator-activated receptors G enes involved in the pathogenesis of complex clinical disorders including essential hypertension and the metabolic syndrome are often referred to as quantitative trait loci (QTL). Identification of QTL at the molecular level is considered to be 1 of the major challenges in modern medicine, and it is hoped that QTL discovery in animal models and in humans will reveal mechanistic pathways that can ultimately serve as new targets for therapeutic intervention. The spontaneously hypertensive rat (SHR) and the Dahl salt-sensitive rat are the most widely studied animal models of spontaneous hypertension, and their value for investigating the pharmacology and pathophysiology of hypertension and cardiovascular disease has been recognized for many years. 1-3 Until recently, however, it was unclear whether these spontaneous animal models of hypertension would prove useful for the identification of naturally occurring gene variants involved in the regulation of blood pressure (BP) or related cardiovascular and metabolic phenotypes. It was also unknown whether any such genes would prove relevant to the pathogenesis and treatment of any clinical disorders in humans.Major advances in methods for QTL mapping, together with the pioneering research of Rapp 4 and other investigators, sparked multiple efforts to map genes influencing BP-related phenotypes in Dahl rats and in the SHR. These ...

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Safety of Telmisartan in Patients with Arterial Hypertension

Abstract: The safety and efficacy of telmisartan found in controlled studies is maintained in a large postmarketing population that included sizeable patient subgroups potentially at higher risk for adverse events.

Cited by 58 publications

References 28 publications

Effects of telmisartan on office and 24-hour ambulatory blood pressure: an observational study in hypertensive patients managed in primary care

Effects of telmisartan on office and 24-hour ambulatory blood pressure: an observational study in hypertensive patients managed in primary care

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms

Molecular Genetics of Experimental Hypertension and the Metabolic Syndrome

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