¹A Michallon Hospital, Grenoble, France

²Hypertension Research Unit, Centre Hospitalier Université Laval, Quebec, Canada

Correspondence to: Professor Jean-Michel Mallion, A.Michallon Hospital, 38043 Grenoble, France

The antihypertensive efficacy and tolerability profiles of the selective AT₁ receptor antagonists telmisartan and losartan were compared with placebo in a 6-week, multinational, multicentre, randomised, double-blind, double-dummy, parallel-group study of 223 patients with mild-to-moderate hypertension, defined as clinic diastolic blood pressure (DBP) 95 and 114 mm Hg, clinic systolic blood pressure (SBP) 140 and 200 mm Hg, and 24-h ambulatory DBP 85 mm Hg. After a 4-week single-blind placebo run-in, eligible patients were randomised to receive telmisartan 40 mg, telmisartan 80 mg, losartan 50 mg, or placebo. Ambulatory blood pressure monitoring (ABPM) after 6 weeks of double-blind therapy showed that all active treatments produced significant (P < 0.01) reductions from baseline in 24-h mean sbp and dbp compared with placebo. during the 18-to-24 h period after dosing, the reductions in sbp/dbp with telmisartan 40 mg (10.7/6.8 mm hg) and 80 mg (12.2/7.1 mm hg) were each significantly (P <0.05) greater than those observed for losartan 50 mg (6.0/3.7 mm hg), and losartan was no better than placebo. also for the 24-h mean blood pressure, telmisartan 40 mg and 80 mg were significantly (P< 0.05) better than losartan 50 mg. compared with losartan, telmisartan 80 mg produced significantly (P < 0.05) greater reductions in both sbp and dbp during all monitored periods of the 24-h period, while telmisartan 40 mg produced significantly greater reductions in sbp and dbp in the night-time period (10.01 pm to 5.59 am) (P < 0.05) and in dbp in the morning period (6.00 am to 11.59 am) (P < 0.05). all treatments were comparably well tolerated. telmisartan 40 mg and 80 mg once daily were effective and well tolerated in the treatment of mild-to-moderate hypertension, producing sustained 24-h blood pressure control which compared favourably with losartan.

telmisartan; losartan; efficacy; ABPM