Ambulatory blood pressure monitoring to assess the comparative efficacy and duration of action of a novel new angiotensin II receptor blocker-telmisartan

Although a wide range of antihypertensive agents is available, adequate blo od pressure control is achieved in only about 25% of hypertensive patients. Poor control rates are often due to inadequate patient compliance and unac ceptable side-effects. The importance of once-daily dosing is now fully ack nowledged, but it is crucial that therapy when given once a day must be eff ective at the end of the dosing interval to order to minimize the likelihoo d of sudden cardiac death, myocardial infarction and stroke. Ambulatory blo od pressure monitoring (ABPM) provides a thorough assessment of the blood p ressure-lowering characteristics of an antihypertensive agent throughout th e dosing interval and can more accurately evaluate differences in the durat ion of the antihypertensive effect of different agents. Telmisartan, a new angiotensin II receptor antagonist, has been extensively studied in clinica l trials using ABPM. When compared with dihydropyridine calcium antagonists , B-adrenergic blockers, angiotensin-converting enzyme inhibitors and other angiotensin II receptor antagonists, telmisartan has proved superior in di minishing ambulatory blood pressure throughout the 24-h period between dose s. Telmisartan also has excellent tolerability and in clinical trials demon strates no increase, irrespective of dose level, over placebo in the incide nce of adverse events. Thus, telmisartan given once daily provides high eff icacy and tolerability, and will hopefully assist in improving both blood p ressure control rates and cardiovascular outcomes in the future.