Telmisartan for the reduction of cardiovascular morbidity and mortality

Abstract

Cardiovascular disease (CVD) poses a significant healthcare and economic burden on societies and individuals. Angiotensin II is a key component of the renin–angiotensin system that plays a central role in atherosclerotic mechanisms that contribute to CVD. Renin–angiotensin system blockers are widely used to reduce cardiovascular (CV) risk owing to their potential both to lower blood pressure, a CV risk factor, and to attenuate the atherosclerotic disease process directly. Telmisartan has a number of pharmacological properties that distinguish it from other angiotensin II receptor blockers (ARBs) – the longest plasma half-life, highest lipophilicity and strongest receptor binding affinity in class. The ONTARGET^® trial showed that telmisartan is as effective as ramipril in reducing CV morbidity (including myocardial infarction and stroke) and mortality in a broad range of patients at increased CV risk. Evidence from other ARBs remains largely restricted to patients with heart failure, diabetic nephropathy or specific subsets of hypertensive patients. Telmisartan is, therefore, the only ARB with a broad indication for CV risk reduction in patients with atherothrombotic disease or diabetes with end-organ damage.

Keywords::

• angiotensin II receptor blocker
• ARB
• cardiovascular disease
• cardiovascular protection
• cardiovascular risk
• ONTARGET^®
• telmisartan
• TRANSCEND^®

Financial & competing interests disclosure

Paolo Verdecchia, Gianpaolo Reboldi and Fabio Angeli have received honoraria for holding conferences or for participation in consultancy from companies manufacturing antihypertensive drugs. Paolo Verdecchia received a research grant from the nonprofit organisation, Fondazione Umbra Cuore e Ipertensione. The authors meet the criteria for authorship as recommended by the International Committee of Medical Journal Editors and were fully responsible for all content and editorial decisions, and were involved at all stages of manuscript development. The authors received no compensation related to the development of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing and editorial assistance was provided by Lisa Buttle of PAREXEL MS. This was contracted and funded by Boehringer Ingelheim.