- SUNDAY, Aug. 31 (HealthDay News) — A new study offers a possible
alternative to heart patients and diabetics who need to keep their blood
pressure under control but who cannot tolerate the standard treatment of
ACE inhibitors.

Reporting at the European Society of Cardiology in Munich on Sunday,
Canadian researchers said they found that the angiogenesis-receptor
blocker (ARB) known as telmisartan worked well for the 20 percent of
patients with vascular disease and high-risk diabetes who can't take ACE
inhibitors. The study was released in the Aug. 31 online issue of The
Lancet to coincide with the meeting presentation.

In the randomized, controlled trial, almost 6,000 patients with
vascular disease or high-risk diabetes took either telmisartan or a
placebo, and were followed for almost five years. Rates of death, heart
attack, stroke or hospitalization for heart failure were tracked as
primary outcome measures during the study period.

Mean blood pressure was lower in the telmisartan group by 4.0/2.2
mm/Hg, and there was a relative risk reduction of 13.3 percent for those
taking telmisartan. Fewer patients on the medication wound up in the
hospital for cardiovascular problems (30.3 percent), compared to those on
placebo (33 percent).

“These data suggest that telmisartan confers a modest benefit when
added to other proven therapies,” the researchers wrote in a news release
from the journal. “In view of the drug's tolerability and effect on
cardiovascular endpoints, telmisartan could be regarded as a potential
treatment for patients with vascular disease or high-risk diabetes, if
they are unable to tolerate an ACE inhibitor.”

However, an accompanying commentary from U.S. experts dampened the
significance of the finding.

“ARBs that have been studied in coronary disease are safe, but possibly
less effective alternatives in patients with intolerance to ACE
inhibitors. Although data are too limited to reach definitive conclusions,
the clinical effect of ARBs seems less robust than that of ACE
inhibitors,” wrote Dr. Toni Ripley and Dr. Donald Harrison, from the
University of Oklahoma College of Pharmacy.

And U.S. researchers reported on Wednesday that telmisartan does not
lower the rate of stroke, cardiovascular events or diabetes better than a
placebo in patients who have had a stroke.

More information

For more on ARBs, go to U.S. Food and Drug Administration.