Use of ambulatory blood pressure monitoring to evaluate the selective angiotensin II receptor antagonist, telmisartan, and other antihypertensive drugs

Telmisartan (Micardis(R)) is a new, orally active, long-acting angiotensin (Ang) II receptor antagonist that is effective in the treatment of hyperten sion. Ambulatory blood pressure monitoring (ABPM) has emerged as an importa nt method for evaluating the consistency of the antihypertensive effects of a drug throughout the dosing interval. ABPM was used to evaluate the antih ypertensive efficacy of telmisartan in several placebo-controlled, double-b lind, multicenter studies. Patients with mild-to-moderate hypertension were allocated randomly to groups to receive telmisartan 40 or 80 mg, losartan 50 mg, or placebo, once daily in a 6-week, fixed-dose study, or telmisartan 40-120 mg, amlodipine 5-10 mg, or placebo, once daily in a 12-week, dose-t itration study. Patients treated with telmisartan 40 and 80 mg or placebo i n a separate 4-week, fixed-dose study were included in an additional analys is. Telmisartan 40 and 80 mg significantly decreased mean ambulatory systol ic blood pressure (SBP) and diastolic blood pressure (DBP) relative to plac ebo for the entire 24 h period and in the following intervals: day (6 a.m. to 10 p.m.), morning (6 a.m. to noon), night (10 p.m, to 6 a.m), and the la st 4 h of the dosing interval (P < 0.01), Notably, telmisartan 40 or 80 mg was more effective than losartan, especially during the last 4-6 h of the d osing interval (P < 0.05), Telmisartan 40-120 mg tended to be more effectiv e than amlodipine 5-10 mg in reducing SEP and DBP in each time interval, wi th significant differences between treatments noted for DBP in the last 4 h of the dosing interval and in the morning (P < 0.05), ABPM also revealed t hat the magnitude of the blood pressure decreasing effect with telmisartan was consistent throughout the dosing interval. These results demonstrate th at telmisartan maintains a normal circadian blood pressure pattern and prov ides full 24 h blood pressure control with once-daily dosing. Blood Press M onit 5 (suppl 1):S35-S40 (C) 2000 Lippincott Williams & Wilkins.