ONCE-DAILY TELMISARTAN COMPARED WITH ENALAPRIL IN THE TREATMENT OF HYPERTENSION

This multicenter, randomized, parallel-group study, which included 440 patients with mild to moderate hypertension, compared the efficacy an d safety of various doses of telmisartan, a specific AT(1)-receptor an tagonist, with those of enalapril and placebo. Following a 4-week plac ebo run-in period, eligible patients received one of six treatments: t elmisartan 40 mg (n = 72), 80 mg (n = 72), 120 mg (n = 73), or 160 mg (n = 75); placebo (n = 76); or enalapril 20 mg (n = 72). Baseline bloo d pressure, determined at the end of the placebo run-in, was compared with trough blood pressure during the 12 weeks of therapy. All doses o f once-daily telmisartan and enalapril significantly (P<.05) reduced b oth systolic (SBP) and diastolic (DBP) blood pressure compared with pl acebo. Final reductions for all telmisartan doses ranged from 10.0-11. 9/8.6-9.7 mm Hg. Final reductions with enalapril were 8.2/7.2 mm Hg. T elmisartan 40 mg produced a full therapeutic response in terms of the percentage of patients achieving normalization (DBP <90 mm Hg), with n early maximal effects by week 4. Compared with enalapril, DBP reductio ns observed at week 12 either approached or achieved statistical signi ficance for telmisartan 40 mg (P = .08) and 80 mg (P = .03), as did SE P reductions for telmisartan 40 mg (P = .06), 80 mg (P = .01), 120 mg (P = .08), and 160 mg (P = .04). The percentage of patients with treat ment-related adverse events was somewhat lower for telmisartan (7.5%) than for either enalapril (13.9%) or placebo (10.5%). Incidences of tr eatment-related cough were 4.2% with enalapril, 0.3% with telmisartan, and 1.3% with placebo. One enalapril-treated patient experienced angi oedema. The antihypertensive efficacy of telmisartan was at least comp arable to that of enalapril, with tolerability similar to that of plac ebo.