A Review of Telmisartan in the Treatment of Hypertension: Blood Pressure Control in the Early Morning Hours
نویسنده
چکیده
Measurement of blood pressure in the clinic may provide a false impression of blood pressure control. Ambulatory blood pressure monitoring (ABPM) allows the automatic recording of the circadian variation in blood pressure and evaluation of the efficacy of antihypertensive medication throughout the dosing interval. Ambulatory blood pressure provides more effective prediction of cardiovascular risk; blood pressure control at the time of heightened risk in the early morning after waking and before taking the next dose of medication is becoming important in order to improve long-term prognosis. To achieve blood pressure control in the early morning, a long-acting antihypertensive agent is essential. Telmisartan, an angiotensin II receptor blocker, as well as having a terminal elimination half-life of 24 h, has a large volume of distribution due to its high lipophilicity. The efficacy of telmisartan 80 mg monotherapy has been demonstrated using ABPM, with superior reduction in mean values for the last 6 h of the dosing interval compared with ramipril 10 mg and valsartan 80 mg. In addition, telmisartan 80 mg provides superior blood pressure control after a missed dose compared with valsartan 160mg. When combined with hydrochlorothiazide (HCTZ) 12.5 mg, telmisartan 40mg and 80mg is more effective than losartan/HCTZ (50/12.5 mg) at the end of the dosing interval. Furthermore, greater reductions in last 6 h mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) are achieved with telmisartan/HCTZ (80/12.5 mg) than with valsartan/HCTZ (160/12.5 mg) in obese patients with type 2 diabetes and hypertension. Recent data from a large group of patients show that telmisartan 80 mg controls the early morning blood pressure surge more effectively than ramipril 5-10 mg and, thus, may have a greater beneficial effect on long-term cardiovascular risk. This supposition is being tested in the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) programme.
منابع مشابه
Comparison of the efficacy of morning versus evening administration of telmisartan in essential hypertension.
Valsartan administration at bedtime as opposed to on wakening improves the sleep time-relative blood pressure decline toward a more dipper pattern without loss in 24-hour efficacy. Yet to be determined is whether this administration time-dependent efficacy is a class-related feature, characteristic of all angiotensin receptor blockers or specific only to valsartan. Terminal half-life is a major...
متن کامل24-hour powerful blood pressure lowering – essential for target organ protection
Circadian blood pressure rhythm is controlled by intracellular molecular clocks, which allow the body to prepare for anticipated stimuli, the morning blood pressure surge helping to meet the challenges of the day while the nocturnal blood pressure fall sets the system for a period of rest. These rhythms vary in hypertensive and non-hypertensive individuals (Fig. 1). Cardiovascular outcomes are ...
متن کاملThe ethnopharmacological review of medicinal plants in uses hypertension treatment in Iranian complementary medicine
Background & Aim: One of the most common diseases in the world, especially among Iranian people, is high blood pressure which can cause many cardiovascular disorders such as heart attack. The disease is often associated with other diseases such as diabetes and hyperlipidemia. Methyldopa and captopril are the most common drugs among several medications used to control blood pres...
متن کاملThe ethnopharmacological review of medicinal plants in uses hypertension treatment in Iranian complementary medicine
Background & Aim: One of the most common diseases in the world, especially among Iranian people, is high blood pressure which can cause many cardiovascular disorders such as heart attack. The disease is often associated with other diseases such as diabetes and hyperlipidemia. Methyldopa and captopril are the most common drugs among several medications used to control blood pres...
متن کاملTelmisartan/hydrochlorothiazide versus valsartan/hydrochlorothiazide in obese hypertensive patients with type 2 diabetes: the SMOOTH study
BACKGROUND The Study of Micardis (telmisartan) in Overweight/Obese patients with Type 2 diabetes and Hypertension (SMOOTH) compared hydrochlorothiazide (HCTZ) plus telmisartan or valsartan fixed-dose combination therapies on early morning blood pressure (BP), using ambulatory BP monitoring (ABPM). METHODS SMOOTH was a prospective, randomized, open-label, blinded-endpoint, multicentre trial. A...
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عنوان ژورنال:
- Vascular Health and Risk Management
دوره 2 شماره
صفحات -
تاریخ انتشار 2006