New drug reduces reduces risk of heart attack, strokes

Washington, Sep 1 : A drug used to lower blood pressure also cuts the risk of cardiovascular death, heart attack or stroke in people who are unable to tolerate a readily available and effective treatment.

The study on the drug, telmisartan, was led by Salim Yusuf and Koon Teo, professors at the Michael G. DeGroote School of Medicine of McMaster University, Canada.

"The remarkable tolerability of telmisartan is emphasised by the fact that fewer individuals stop medication if they were receiving telmisartan compared to a placebo," said Teo, the project director.

"This is particularly noteworthy, as all the individuals enrolled in the study were unable to tolerate an ACE inhibitor, which is a closely related class of agents."

The research results will be published online by The Lancet.

ACE inhibitors, or angiotensin-converting-enzyme inhibitors, are widely used and effective medications used to lower blood pressure (BP). They work by helping to widen blood vessels to improve blood flow.

Approximately 20 percent 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 BP, 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.

The TRANSCEND (Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease) study enrolled nearly 6,000 people worldwide who are intolerant to ACE inhibitors, and evaluated whether telmisartan - compared to a 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. Physicians were also free to use other medications that could lower BP.

Researchers found that telmisartan reduced the outcome of cardiovascular death, heart attack, stroke or hospitalisation for heart failure by a relative eight percent (17 percent in the placebo experienced those cardiac events compared to 15.8 percent in the telmisartan group). This difference was not statistically significant.