Hypertension is considered a major health problem around the world. It’s associated with increasing risk of mortality due to its complication which has a great impact on patient’s life quality. Angiotensin Receptor Blocker has been widely used to manage hypertension, especially if diabetes coexists and the patient is less tolerable to angiotensin-converting enzyme inhibitors. In particular, telmisartan has been studied either as a monotherapy or combined with other antihypertensive agents. This study aims to understand the efficacy, safety, and tolerability of telmisartan as monotherapy or, in combination, is it superior to other agents? We used the PubMed database to search for relevant articles on the topic. Telmisartan administration showed excellent 24-hour protection against elevated BP, particularly in the early morning BP surge, which is the most expected period where cardiovascular events or strokes occur. In patients resistant to monotherapy, the use of telmisartan combinations provides better BP control compared to other agents, especially in the triple combination, where the drug's side effects are significantly decreased.
1. Almuqati AL, Alluqmani MS, Balhareth SH, Alosaimi MA, Alosaimi MM, Alzughaibi AM, et al. Evaluation of Role of Family Physicians in Management and Diagnosis of Hypertension in Primary Health Care Centers: A Simple Literature Review. J Adv Pharm Educ Res. 2020;9(1):105-9.
2. Sinuraya RK, Rianti A, Suwantika AA. Cost minimization of cardiovascular disease (CVD) drugs in primary healthcare centers in Bandung, Indonesia. J Adv Pharm Edu Res. 2021;10(1):63-9.
3. Chrysant SG, Chrysant GS, Desai A. Current status of angiotensin receptor blockers for the treatment of cardiovascular diseases: focus on telmisartan. J Hum Hypertens. 2005;19(3):173-83. Available from: doi:10.1038/sj.jhh.1001808
4. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560-72. doi:10.1001/jama.289.19.2560
5. Marques-Vidal P, Tuomilehto J. Hypertension awareness, treatment and control in the community: is the ‘rule of halves’ still valid?. J Hum Hypertens. 1997;11(4):213-20. doi:10.1038/sj.jhh.1000426
6. Messerli FH, Bangalore S, Bavishi C, Rimoldi SF. Angiotensin-Converting Enzyme Inhibitors in Hypertension. J Am Coll Cardiol. 2018;71(13):1474-82. Available from: doi:10.1016/j.jacc.2018.01.058
7. Bakris G. Comparison of telmisartan vs. valsartan in the treatment of mild to moderate hypertension using ambulatory blood pressure monitoring. J Clin Hypertens (Greenwich). 2002;4(4 Suppl 1):26-31. doi:10.1111/j.1524-6175.2002.01586.x
8. Nishimura T, Hashimoto J, Ohkubo T, Kikuya M, Metoki H, Asayama K, et al. Efficacy and duration of action of the four selective angiotensins II subtype 1 receptor blockers, losartan, candesartan, valsartan, and telmisartan, in patients with essential hypertension determined by home blood pressure measurements. Clin Exp Hypertens. 2005;27(6):477-89. doi:10.1081/CEH-200067668
9. Grassi G, Quarti-Trevano F, Mancia G. Cardioprotective effects of telmisartan in uncomplicated and complicated hypertension. J Renin Angiotensin Aldosterone Syst. 2008;9(2):66-74. doi:10.3317/jraas.2008.017
10. Stergiou GS, Efstathiou SP, Roussias LG, Mountokalakis TD. Blood pressure- and pulse pressure-lowering effects, trough: peak ratio and smoothness index of telmisartan compared with lisinopril. J Cardiovasc Pharmacol. 2003;42(4):491-6. doi:10.1097/00005344-200310000-00006
11. Lacourcière Y, Krzesinski JM, White WB, Davidai G, Schumacher H. Sustained antihypertensive activity of telmisartan compared with valsartan. Blood Press Monit. 2004;9(4):203-10. doi:10.1097/00126097-200408000-00005
12. Neutel J, Smith DH. Evaluation of angiotensin II receptor blockers for 24-hour blood pressure control: meta-analysis of a clinical database. J Clin Hypertens (Greenwich). 2003;5(1):58-63. doi:10.1111/j.1524-6175.2003.01612.x
13. Smith DK, Lennon RP, Carlsgaard PB. Managing Hypertension Using Combination Therapy. Am Fam Physician. 2020;101(6):341-9.
14. Zheng Z, Lin S, Shi H. A systematic review and meta-analysis of telmisartan versus valsartan in the management of essential hypertension. J Clin Hypertens (Greenwich). 2010;12(6):414-21. doi:10.1111/j.1751-7176.2010.00287.x
15.
16. Bryant J, Ruilope L, Segura J. A review of the benefits of early treatment initiation with single-pill combinations of telmisartan with amlodipine or hydrochlorothiazide. Vasc Health Risk Manag. 2013;9:521.
17. Guthrie RM. Review: a single-pill combination of telmisartan plus amlodipine for the treatment of hypertension. Postgrad Med. 2011;123(6):58-65. doi:10.3810/pgm.2011.11.2495
18. Sharma AM, Davidson J, Koval S, Lacourcière Y. Telmisartan/hydrochlorothiazide versus valsartan/hydrochlorothiazide in obese hypertensive patients with type 2 diabetes: the SMOOTH study. Cardiovasc Diabetol. 2007;6:28. doi:10.1186/1475-2840-6-28
19. Sung KC, Oh YS, Cha DH, Hong SJ, Won KH, Yoo KD, et al. Efficacy and Tolerability of Telmisartan/Amlodipine + Hydrochlorothiazide Versus Telmisartan/Amlodipine Combination Therapy for Essential Hypertension Uncontrolled with Telmisartan/Amlodipine: The Phase III, Multicenter, Randomized, Double-blind TAHYTI Study. Clin Ther. 2018;40(1):50-63.e3. doi:10.1016/j.clinthera.2017.11.006
20. Davis J, Oparil S. Novel Medical Treatments for Hypertension and Related Comorbidities. Curr Hypertens Rep. 2018;20(10):90. doi:10.1007/s11906-018-0890-y
21. Maladkar M, Verma VK, Narsikar KA, Walinjkar RD, Patil WR, Saggu NJS, et al. Triple drug combination of telmisartan, amlodipine, and hydrochlorothiazide in the treatment of essential hypertension. Open J Int Med. 2012;02(02):67-71.
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