BP lowering drug reduces heart attack risk
London, Sept 1 : Telmisartan - a medication used to lower blood pressure - reduces
the outcome of cardiovascular death, heart attack or stroke in people who are unable to
tolerate a widely available and effective standard treatment, according to an
international study led by Canadian researchers.
ACE inhibitors, or angiotensin-converting-enzyme inhibitors, are widely used and
effective medications used to lower blood pressure. They work by helping to widen blood
vessels to improve blood flow.
However, approximately 20 per cent of patients who could benefit from an ACE inhibitor
stop taking it because of cough, kidney problems, swelling or symptomatic low blood
pressure.
Telmisartan is a type of angiotensin-receptor blocker, or ARB. Like ACE inhibitors,
telmisartan also lowers blood pressure, but works in a different manner.
ARBs block the receptor sites in the body for angiotensin II, a naturally occurring
hormone that constricts blood vessels and increases blood pressure.
For the study, lead authors Dr. Salim Yusuf and Dr. Koon Teo, professors in the Michael
G. DeGroote School of Medicine at McMaster University and clinicians at Hamilton Health
Sciences, enrolled nearly 6,000 people worldwide who are intolerant to ACE inhibitors, and
evaluated whether telmisartan - compared to placebo - would reduce the risk of major
cardiovascular events.
A high proportion of patients received proven therapies, such as statins, anti-platelet
agents and beta-blockers. Doctors were also free to use other medications that could lower
blood pressure.
The researchers found that the outcome of cardiovascular death, heart attack or stroke
was modestly reduced when patients took telmisartan.
Also, fewer patients receiving telmisartan were hospitalised for any cardiovascular
reason compared to placebo.
Telmisartan was also remarkably well tolerated, and fewer patients on telmisartan
discontinued the medication compared to placebo.
It reduced the outcome of cardiovascular death, heart attack, stroke or hospitalization
for heart failure by a relative eight per cent (17 per cent in the placebo experienced
those cardiac events compared to 15.8 per cent in the telmisartan group). This difference
was not statistically significant.
However, when the outcome included cardiovascular death, heart attack or stroke (and
not hospitalization for heart failure), telmisartan reduced that outcome by a significant
13 per cent (14.8 per cent in the placebo group experienced those cardiac events compared
to 13 per cent with telmisartan).
"The TRANSCEND study demonstrates the value of telmisartan in people who are unable to
tolerate angiotensin converting enzyme inhibitors," The Lancet quoted principal
investigator Dr. Yusuf, director of the Population Health Research Institute at McMaster
University, as saying.
The study is published online by The Lancet and presented at this year's European Society
of Cardiology Congress in Munich, Germany.
--ANI
