Optimal dosing characteristics of the angiotensin II receptor antagonist telmisartan

An optimal antihypertensive drug produces superior blood pressure–lowering effects at established dosages, with an acceptably low incidence of side effects, and at a dosage interval that is convenient for patients (ideally, once daily). The angiotensin II receptor antagonist, telmisartan, meets these criteria. At doses of ≥40 mg, this once-daily drug produces a statistically significant reduction in blood pressure. Ambulatory blood pressure monitoring (ABPM) and high trough–peak ratios attest to the smooth, consistent blood pressure–lowering effect of telmisartan at 40- and 80-mg dosages. Telmisartan also demonstrates a statistically superior antihypertensive effect toward the end of the dosing interval compared with amlodipine and losartan, and it has a side-effect profile comparable to that of placebo. In summary, the evidence suggests that telmisartan at dosages of 40 and 80 mg once daily satisfies the 3 criteria of an ideal antihypertensive agent, producing an effective and sustained response with placebo-like tolerability.