The Current Update on the Efficacy of Telmisartan in Patients with Hypertension: A Systematic Review

Abstract

Hypertension is a chronic condition which is often found worldwide and becomes a major risk factor for cardiovascular disease. Initial antihypertensive therapy with Angiotensin Receptor Blocker can be used for patients who have intolerance to Angiotensin-Converting Enzyme Inhibitors, such as telmisartan. Telmisartan can be taken as monotherapy or in combination with other antihypertensive drugs. This study was designed to review the current update on the efficacy of telmisartan in patients with hypertension as single-dose or doubledose monotherapy or in combination therapy. Methods: We searched the PubMed, ScienceDirect, and Hindawi databases for terms related to telmisartan efficacy as single-dose or double-dose monotherapy, in combination with amlodipine or hydrochlorothiazide, and as therapy for hypertension with diabetes or for dyslipidemia patients with blood pressure and TGs or LDL cholesterol or post-meal blood sugar or fasting insulin or fasting plasma glucose. The articles matching the restriction criteria were then passed the PRISMA flowchart. The quality of the articles was tested using the GRADE method. Results: The article searches found 1033 journals, 12 articles were eligible for systematic review with high-grade result, 1 article with moderate-grade result, and 1 article with low-grade result based on the GRADE method. The review of articles on telmisartan single-dose monotherapy showed significantly reduced blood pressure (±5.61/5.15 mmHg) and 21.8 ± 5.592/16.00 ± 5.965 mmHg when used as double-dose therapy. The combination of telmisartan with amlodipine showed a highly significant effect to reduce blood pressure (−15.3 ± 11.2/−8.0 ± 8.6 mmHg) after 8 weeks, and with hydrochlorothiazide it was −31.1−18.1 mmHg in 8 weeks. For hypertension patients with diabetes, telmisartan has significantly reduced blood pressure (−24.9/−19.5 mmHg), post-meal blood sugar (−36.9 mg/dL) after 12 weeks, and FPG (−1.06 mg/dL) as well as fasting insulin (−0.818 μU/mL). Telmisartan has good tolerability for treatment with anti-cholesterol drugs. Conclusion: Telmisartan is favorable and effective for the treatment of patients with hypertension as single-dose and double-dose monotherapy, in combination with amlodipine or hydrochlorothiazide, and therapy for hypertension with diabetes or dyslipidemia patients.