Telmisartan: just an antihypertensive agent? A literature review.

Abstract

INTRODUCTION:

The modulation of the renin angiotensin aldosterone system (RAAS) is an important pathway in managing high blood pressure, and its overexpression plays a key role in target end-organ damage. Telmisartan is an angiotensin II receptor blocker (ARB) with unique pharmacologic properties, including the longest half-life among all ARBs; this leads to a significant and 24-h sustained reduction of blood pressure. Telmisartan has well-known antihypertensive properties, but there is also strong clinical evidence that it reduces left ventricular hypertrophy, arterial stiffness and the recurrence of atrial fibrillation, and confers renoprotection.

AREAS COVERED:

This paper reviews telmisartan's pharmacological properties in terms of efficacy for hypertension control and, importantly, focuses on its new therapeutic indications and their clinical implications.

EXPERT OPINION:

ONTARGET (ongoing telmisartan alone and in combination with ramipril global endpoint trial) demonstrated, that telmisartan confers cardiovascular protective effects similar to those of ramipril, but with a better tolerability. Moreover, recent investigations focused on the capability of telmisartan to modulate the peroxisome proliferator-activated receptor-gamma (PPAR-γ), an established target in the treatment of insulin resistance, diabetes and metabolic syndrome, whose activation is also correlated to anti-inflammatory and, finally, anti-atherosclerotic properties. Telmisartan shows peculiar features that go beyond blood pressure control. It presents promising and unique protective properties against target end-organ damage, potentially able to open a scenario of new therapeutic approaches to cardiovascular disease.

• Authors: Maurizio Destro, Francesca Cagnoni, Giuseppina Patrizia Dognini, Vincenzo Galimberti, Carlo Taietti, Chiara Cavalleri, Emilio Galli
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 12 Issue 17 Pg. 2719-35 (Dec 2011) ISSN: 1744-7666 [Electronic] England
• PMID: 22077832 (Publication Type: Journal Article, Review)

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Antihypertensive Agents
• Benzimidazoles
• Benzoates
• Telmisartan

Topics

• Angiotensin II Type 1 Receptor Blockers (economics, pharmacology, therapeutic use)
• Animals
• Antihypertensive Agents (economics, pharmacology, therapeutic use)
• Atrial Fibrillation (prevention & control)
• Benzimidazoles (economics, pharmacology, therapeutic use)
• Benzoates (economics, pharmacology, therapeutic use)
• Costs and Cost Analysis
• Humans
• Hypertension (drug therapy, economics, metabolism)
• Hypertrophy, Left Ventricular (prevention & control)
• Kidney Diseases (prevention & control)
• Renin-Angiotensin System
• Telmisartan