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Review: Cardioprotective effects of telmisartan in uncomplicated and complicated hypertension

Department of Internal Medicine and Cardiovascular Prevention, S Gerardo Hospital, University of Milano-Bicocca, Monza Milan, Center of Clinical Physiology and Hypertension, Milan, Italy, guido.grassi{at}unimib.it

Fosca Quarti-Trevano

Department of Internal Medicine and Cardiovascular Prevention, S Gerardo Hospital, University of Milano-Bicocca, Monza Milan, Center of Clinical Physiology and Hypertension, Milan, Italy

Giuseppe Mancia

Department of Internal Medicine and Cardiovascular Prevention, S Gerardo Hospital, University of Milano-Bicocca, Monza Milan, Center of Clinical Physiology and Hypertension, Milan, Italy

The development of angiotensin II receptor blockers (ARB) as a new class of drugs for the management of hypertension has elicited the attention of many clinicians worldwide with the aim of improving blood pressure (BP) control as well as cardiovascular protection.AmongARB telmisartan has been shown to be characterised by an antihypertensive efficacy fully covering the 24-hour period, thereby allowing to antagonise the adverse effects of early morning BP rise on cardiovascular risk. Other specific effects of the drug are represented by its favourable metabolic profile (particularly on insulin sensitivity) and neutral effects on sympathetic cardiovascular function.These properties are coupled with cardioprotective effects, documented by the evidence that the drug: 1) is effective in favouring the regression of cardiac and vascular organ damage, 2) reduces arterial stiffness and improves vascular distensibility and 3) reverses the endothelial dysfunction typical of the hypertensive state particularly when complicated by renal failure, diabetes, obesity or metabolic syndrome. Several of these properties can account for the results of the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET), documenting the beneficial effects on the drug on cardiovascular morbidity and mortality.

Key Words: angiotensin II receptor antagonists • blood pressure control • cardiac protection • endothelial function • left ventricular hypertrophy • insulin resistance • target organ damage • vascular protection • 24-hour ambulatory blood pressure monitoring

Journal of Renin-Angiotensin-Aldosterone System, Vol. 9, No. 2, 66-74 (2008)
DOI: 10.3317/jraas.2008.017


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