Telmisartan Shows Organoprotection and Reduces the Incidence of Adverse Cardiovascular Outcomes in Addition to the Antihypertensive Effect
In previously published review the unique antihypertensive and metabolic properties of telmisartan were described. This drug lowers blood pressure well during the night and in the morning. It is characterized by a high homogeneity of the pressure drop during the day and the occasional missing the dose does not lead to serious consequences. High efficacy/safety ratio was noted for this drug, including in comparison with other antihypertensive agents. In addition, telmisartan reduced the severity of disorders of carbohydrate (insulin resistance) and lipid metabolism, reduced systemic inflammatory response and a tendency to thrombosis. In this review of clinical trials organoprotective (vessels, heart, kidney) effects of telmisartan and its ability to prevent the development of adverse cardiovascular outcomes were justified. Telmisartan improved vascular function by reducing endothelial dysfunction, arterial stiffness, and the thickness of the intima-media, increasing the number of endothelial progenitor cells, reducing the incidence of restenosis after stent placement and stabilization of atherosclerotic plaques in coronary arteries; improved cardiac function by reducing left ventricular hypertrophy, increasing left ventricular function, reducing the incidence of atrial fibrillation recurrence; improved renal function by reducing the severity of nephropathy; reduced the risk of adverse cardiovascular outcomes such as death from cardiovascular causes, incidence of nonfatal myocardial infarction and nonfatal stroke, hospitalization for heart failure, overall mortality. Telmisartan is the only angiotensin receptor blocker recom-mended for a wide range of patients at high cardiovascular risk.