EFFICACY OF TELMISARTAN AND ATENOLOL IN MANAGEMENT OF ESSENTIAL HYPERTENSION
Abstract
Background: Telmisartan and atenolol are widely used in the management of essentialhypertension. This study was conducted to compare the efficacy of these two drugs in managementof patients of essential hypertension. Methods: Diagnosed patients of essential hypertension wereselected. Therapeutic option (telmisartan/atenolol) was allocated to the patients by lottery methodand they were divided into two groups. The patients were followed on subsequent visits (4 in total)and their sitting systolic and diastolic blood pressures were recorded. Results: Total number of 180patients were divided into two treatment groups (i.e., telmisaran and atenolol). Forty percent weremale and 60% were female. Majority of the patients were of age group 56–75 years. Telmisartanreduced systolic and diastolic blood pressure significantly compared to atenolol at the end of 8 weeksof treatment (p=0.000 and 0.016 respectively). Conclusion: Telmisartan 80 mg once daily is moreeffective than atenolol 50 mg once daily in lowering systolic and diastolic blood pressure at the endof 8 weeks of treatment.Keywords: Telmisartan, Angiotensin II receptor blocker, atenolol, beta blocker, hypertensionReferences
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK,
He J. Global burden of hypertension: analysis of worldwide data.
Lancet 2005;365:217–23.
Ogihara T, Saruta T, Rakugi H, Matsuoka H, Shimamoto K,
Shimada K, et al. Target blood pressure for treatment of isolated
systolic hypertension in the elderly: valsartan in elderly isolated
systolic hypertension study. Hypertension 2010;56:196–202.
Pullicino PM, McClure LA, Wadley VG, Ahmed A, Howard VJ,
Howard G, et al. Blood pressure and stroke in heart failure in the
reasons for geographic and racial differences in stroke
(REGARDS) Study. Stroke 2009;40:3706–10.
Midha T, Idris M, Saran R, Srivastava A, Singh S. Isolated
systolic hypertension and its determinants -a cross-sectional study
in the adult population of Lucknow District in North India. Indian
J Community Med 2010;35:89–93.
Hyman DJ, Pavlik VN. Characteristics of patients with
uncontrolled hypertension in the United States. N Engl J Med
;345:479–86.
Lloyd-Jones DM, Evans JC, Larson MG, O’Donnell CJ,
Roccella EJ, Levy D. Differential control of systolic and diastolic
blood pressure: factors associated with lack of blood pressure
control in the community. Hypertension 2000;36:594–9.
Cushman WC, Ford CE, Cutler JA, Margolis KL, Davis BR,
Grimm RH, et al. Success and predictors of blood pressure
control in diverse North American settings: The Antihypertensive
and Lipid-Lowering Treatment to Prevent Heart Attack Trial
(ALLHAT). J Clin Hypertens 2002;4:393–404.
Black HR, Elliott WJ, Neaton JD, Grandits G, Grambsch P,
Grimm R, et al. Baseline characteristics and early blood pressure
control in the CONVINCE trial. Hypertension 2001;37:12–8.
Stafylas PC, Sarafidis PA. Carvedilol in hypertension treatment.
Vasc Health Risk Manag 2008;4:23–30.
Epstein BJ, Anderson S. Discordant effects of beta blockers on
central aortic systolic and brachial systolic blood pressure:
considerations beyond the cuff. Pharmacotherapy 2007;27:1322–33.
Wu A. Should beta-blockers still be used as initial
antihypertensive agents in uncomplicated hypertension? Ann
Acad Med Singapore 2007;36:962–4.
Krum H, Gilbert RE. Novel therapies blocking the reninangiotensin-aldosterone system in management of hypertension
and related disorders. J Hypertens 2007;25:25–35.
Ramón C, Hermida, Diana E, Ayala, José R, Fernández, et al.
Comparison of the efficacy of morning versus evening
administration of telmisartan in essential hypertension.
Hypertension 2007;50:715–22.
Jamali S, Mashori GR, Maher Z, Khan M. Comparison of
candesartan cilexetil and atenolol in essential hypertensive
patients. Med Channel 2008;14:28–31.
Maillard MP, Burnier M. Is the fixed-dose combination of
telmisartan and hydrochlorothiazide a good approach to treat
hypertension? Vasc Health Risk Manag 2007;3:265–78.
Sharma AM, Davidson J, Koval S, Lacourcière Y. Telmisartan/
hydrochlorothiazide versus valsartan/hydrochlorothiazide in obese
hypertensive patients with type 2 diabetes: the SMOOTH study.
Cardiovasc Diabetol 2007;6:28.
Petkow-Dimitrow P. New therapeutic targets for ACE inhibitors
and angiotensin receptor blockers. Pol Arch Med Wewn
;117:164–70.
Burnier M, Maillard M. The comparative pharmacology of
angiotensin II receptor antagonists. Blood Press 2001;10:6–11.
Neutel JM, Smith DH. The circadian pattern of blood pressure:
cardiovascular risk and therapeutic opportunities. Curr Opin
Nephrol Hypertens 1997;6:250–6.
Alcocer L, Fernadez-Bonetti P, Campos E, Ruiz RO, Bahena J,
De-La Fuente JJ, et al. Clinical efficacy and safety of telmisartan
mg once daily vs. atenolol 50 mg once daily in patients with
mild to moderate hypertension. Int J Clin Pract 2004;58:35–9.
Freytag F, Schelling A, Meinicke T. Comparison of 26-week
efficacy and tolerability of telmisartan and atenolol, in
combination with hydrochlorothiazide as required, in the
treatment of mild-to-moderate hypertension: a randomized,
multicenter study. Clin Ther 2001;23:108–23.
Conway FJ, Fitzgerald JD, McAinsh J. Human pharmacokinetic
and pharmacodynamic studies on the atenolol, a new
cardioselective beta-adrenoceptor blocking drug. Br J Clin
Pharmacol 1976;3:267–72.
Escudero J, Hernandez H, Martinez F. Comparative study of the
antihypertensive effect of verapamil and atenolol. Am J Cardiol
;57:54–8.
McDevitt DG. Pharmacological characteristics of beta blockers
and their role in clinical practice. J Cardiovasc Pharmacol
;8:5–11.
Cleophas TJ, vd Mey N, Meulen J. Quality of life before and
during antihypertensive treatment: a comparative study of
celiprolol and atenolol. Am J Ther 1997;4:117–22.
Paran E, Anson O, Neumann L. The effects of replacing
betablockers with an angiotensin converting enzyme inhibitor on
the quality of life of hypertensive patients. Am J Hypertens
;9:1206–13.Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK,
He J. Global burden of hypertension: analysis of worldwide data.
Lancet 2005;365:217–23.
Ogihara T, Saruta T, Rakugi H, Matsuoka H, Shimamoto K,
Shimada K, et al. Target blood pressure for treatment of isolated
systolic hypertension in the elderly: valsartan in elderly isolated
systolic hypertension study. Hypertension 2010;56:196–202.
Pullicino PM, McClure LA, Wadley VG, Ahmed A, Howard VJ,
Howard G, et al. Blood pressure and stroke in heart failure in the
reasons for geographic and racial differences in stroke
(REGARDS) Study. Stroke 2009;40:3706–10.
Midha T, Idris M, Saran R, Srivastava A, Singh S. Isolated
systolic hypertension and its determinants -a cross-sectional study
in the adult population of Lucknow District in North India. Indian
J Community Med 2010;35:89–93.
Hyman DJ, Pavlik VN. Characteristics of patients with
uncontrolled hypertension in the United States. N Engl J Med
;345:479–86.
Lloyd-Jones DM, Evans JC, Larson MG, O’Donnell CJ,
Roccella EJ, Levy D. Differential control of systolic and diastolic
blood pressure: factors associated with lack of blood pressure
control in the community. Hypertension 2000;36:594–9.
Cushman WC, Ford CE, Cutler JA, Margolis KL, Davis BR,
Grimm RH, et al. Success and predictors of blood pressure
control in diverse North American settings: The Antihypertensive
and Lipid-Lowering Treatment to Prevent Heart Attack Trial
(ALLHAT). J Clin Hypertens 2002;4:393–404.
Black HR, Elliott WJ, Neaton JD, Grandits G, Grambsch P,
Grimm R, et al. Baseline characteristics and early blood pressure
control in the CONVINCE trial. Hypertension 2001;37:12–8.
Stafylas PC, Sarafidis PA. Carvedilol in hypertension treatment.
Vasc Health Risk Manag 2008;4:23–30.
Epstein BJ, Anderson S. Discordant effects of beta blockers on
central aortic systolic and brachial systolic blood pressure:
considerations beyond the cuff. Pharmacotherapy 2007;27:1322–33.
Wu A. Should beta-blockers still be used as initial
antihypertensive agents in uncomplicated hypertension? Ann
Acad Med Singapore 2007;36:962–4.
Krum H, Gilbert RE. Novel therapies blocking the reninangiotensin-aldosterone system in management of hypertension
and related disorders. J Hypertens 2007;25:25–35.
Ramón C, Hermida, Diana E, Ayala, José R, Fernández, et al.
Comparison of the efficacy of morning versus evening
administration of telmisartan in essential hypertension.
Hypertension 2007;50:715–22.
Jamali S, Mashori GR, Maher Z, Khan M. Comparison of
candesartan cilexetil and atenolol in essential hypertensive
patients. Med Channel 2008;14:28–31.
Maillard MP, Burnier M. Is the fixed-dose combination of
telmisartan and hydrochlorothiazide a good approach to treat
hypertension? Vasc Health Risk Manag 2007;3:265–78.
Sharma AM, Davidson J, Koval S, Lacourcière Y. Telmisartan/
hydrochlorothiazide versus valsartan/hydrochlorothiazide in obese
hypertensive patients with type 2 diabetes: the SMOOTH study.
Cardiovasc Diabetol 2007;6:28.
Petkow-Dimitrow P. New therapeutic targets for ACE inhibitors
and angiotensin receptor blockers. Pol Arch Med Wewn
;117:164–70.
Burnier M, Maillard M. The comparative pharmacology of
angiotensin II receptor antagonists. Blood Press 2001;10:6–11.
Neutel JM, Smith DH. The circadian pattern of blood pressure:
cardiovascular risk and therapeutic opportunities. Curr Opin
Nephrol Hypertens 1997;6:250–6.
Alcocer L, Fernadez-Bonetti P, Campos E, Ruiz RO, Bahena J,
De-La Fuente JJ, et al. Clinical efficacy and safety of telmisartan
mg once daily vs. atenolol 50 mg once daily in patients with
mild to moderate hypertension. Int J Clin Pract 2004;58:35–9.
Freytag F, Schelling A, Meinicke T. Comparison of 26-week
efficacy and tolerability of telmisartan and atenolol, in
combination with hydrochlorothiazide as required, in the
treatment of mild-to-moderate hypertension: a randomized,
multicenter study. Clin Ther 2001;23:108–23.
Conway FJ, Fitzgerald JD, McAinsh J. Human pharmacokinetic
and pharmacodynamic studies on the atenolol, a new
cardioselective beta-adrenoceptor blocking drug. Br J Clin
Pharmacol 1976;3:267–72.
Escudero J, Hernandez H, Martinez F. Comparative study of the
antihypertensive effect of verapamil and atenolol. Am J Cardiol
;57:54–8.
McDevitt DG. Pharmacological characteristics of beta blockers
and their role in clinical practice. J Cardiovasc Pharmacol
;8:5–11.
Cleophas TJ, vd Mey N, Meulen J. Quality of life before and
during antihypertensive treatment: a comparative study of
celiprolol and atenolol. Am J Ther 1997;4:117–22.
Paran E, Anson O, Neumann L. The effects of replacing
betablockers with an angiotensin converting enzyme inhibitor on
the quality of life of hypertensive patients. Am J Hypertens
;9:1206–13.
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