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Telmisartan Shows Modest Cardiovascular Benefit

Still a potential treatment in ACE inhibitor-intolerant patients

MONDAY, Sept. 1 (HealthDay News) -- Telmisartan, an angiotensin-receptor blocker (ARB), is a potential option for patients intolerant of angiotensin-converting enzyme (ACE) inhibitors, although the cardiovascular benefits appear less robust, according to a study and editorial published online Aug. 31 in The Lancet and presented at the European Society of Cardiology Meeting held Aug. 30 to Sept. 3 in Munich, Germany.

Salim Yusuf, M.D., from Hamilton Health Sciences and McMaster University in Hamilton, Ontario, Canada, and colleagues randomly assigned 5,926 patients with cardiovascular disease or diabetes with end-organ damage who were intolerant to ACE inhibitors to 80 mg/day telmisartan or placebo.

After a median of 56 months, the researchers did not find any significant effect on the primary outcome (a composite of cardiovascular death, myocardial infarction, stroke, or hospitalization for heart failure) for those in the telmisartan group compared to placebo. However, when the outcome included only cardiovascular death, heart attack or stroke, telmisartan was associated with a risk reduction of 13 percent compared to placebo. The researchers also noted that fewer telmisartan patients were hospitalized for any cardiovascular reason than placebo patients (30.3 versus 33 percent).

"ARBs that have been studied in coronary disease are safe, but possibly less-effective alternatives in patients with intolerance to ACE inhibitors," write the authors of an accompanying editorial. "Although data are too limited to reach definitive conclusions, the clinical effect of ARBs seems less robust than that of ACE inhibitors.

The study was funded by Boehringer Ingelheim.

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