In the ATTEMPT-CVD trial presented at the ESC Congress 2015, a strategy of angiotensin II-receptor blocker (ARB) therapy with telmisartan was compared with a standard non-ARB strategy in a total of 1,228 patients with hypertension in Japan. In this multicentre, open-label, randomized trial, telmisartan therapy was associated with a smaller increase in plasma brain natriuretic peptide level, and a greater decrease in urinary albumin creatinine ratio than non-ARB treatment, despite similar control of blood pressure. These parameters are known to be strong biomarkers of cardiovascular and renal risk; however, the rate of cardiovascular events did not differ significantly between the two groups.