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 blood pressure control is achieved in only about 25% of hypertensive patients. Poor control rates are often due to inadequate patient compliance and unacceptable side-effects. The importance of once-daily dosing is now fully acknowledged, but it is crucial that therapy when given once a day must be effective at the end of the dosing interval to order to minimize the likelihood of sudden cardiac death, myocardial infarction and stroke. Ambulatory blood pressure monitoring (ABPM) provides a thorough assessment of the blood pressure-lowering characteristics of an antihypertensive agent throughout the dosing interval and can more accurately evaluate differences in the duration of the antihypertensive effect of different agents. Telmisartan, a new angiotensin II receptor antagonist, has been extensively studied in clinical trials using ABPM. When compared with dihydropyridine calcium antagonists, beta-adrenergic blockers, angiotensin-converting enzyme inhibitors and other angiotensin II receptor antagonists, telmisartan has proved superior in diminishing ambulatory blood pressure throughout the 24-h period between doses. Telmisartan also has excellent tolerability and in clinical trials demonstrates no increase, irrespective of dose level, over placebo in the incidence of adverse events. Thus, telmisartan given once daily provides high efficacy and tolerability, and will hopefully assist in improving both blood pressure control rates and cardiovascular outcomes in the future.