Telmisartan - An effective antihypertensive for 24-hour blood pressure control

Hypertension can be managed effectively with a wide range of drugs from different classes. However, different combinations of these agents are frequently required for blood pressure to be sufficiently controlled for patients to reach guideline targets. Telmisartan, an angiotensin II receptor antagonist (AIIRA), is effective in controlling hypertension in a broad population of hypertensive patients, including the elderly and those with comorbid conditions (type 2 diabetes and renal impairment), when used as monotherapy or in combination with the thiazide diuretic, hydrochlorothiazide (HCTZ). Telmisartan, like other AIIRAs, blocks the effects of angiotensin II by competitively binding to angiotensin II type 1 (AT1) receptors. It has a longer plasma half-life than all of the other AIIRAs currently available, which accounts for its extended control of blood pressure over a 24-hour period. This has implications for the control of the early morning surge in blood pressure and thus may help to prevent excess cardiovascular mortality and morbidity (e.g. myocardial infarction [MI] or strokes) which occur at a greater frequency between 6 am and noon. Evidence from clinical trials has shown that telmisartan, with or without HCTZ, has a good tolerability and safety profile, and is better tolerated than angiotensin-converting enzyme (ACE) inhibitors. Taken together, these observations indicate that telmisartan represents a valuable first-line treatment option for the management of hypertension.