Blood pressure-lowering effect of telmisartan compared to losartan among mild to moderate essential hypertensive adult subjects: A meta-analysis

Objective: We conducted a meta-analysis in which the blood pressure (BP)-reducing effect of telmisartan was compared to losartan among hypertensive subjects and its association with ethnicity, age, and gender was investigated. Materials and Methods: PubMed, Google Scholar, and the Cochrane library were searched from inception to April 2021 to obtain relevant articles. Cochrane risk of bias assessment tool was used for assessment of bias risk. GRADE analysis was done for determining the certainty of evidence. Data was analyzed using Revman 5.4.2 software. The pooled mean difference with 95% confidence interval (CI) was computed using random-effects model. Heterogeneity was also assessed using meta-regression and subgroup analysis. This study has been registered in PROSPERO with registration no. CRD42021245122. Results: Fifteen randomized controlled trials (RCTs) with 1926 subjects were selected from various countries. Both systolic BP (SBP) and diastolic BP (DBP) were found to be significantly reduced among telmisartan-treated groups (weighted mean difference [WMD] = 2.69, 95% CI: 1.38-4.00 and WMD = 1.26, 95% CI: 0.45-2.08 respectively). One subgroup analysis noted better reduction in both SBP and DBP among Asian population compared to Caucasians. Conclusion: Telmisartan was found to be a better hypertensive drug compared to losartan in patients with mild to moderate hypertension. Its efficacy was higher in Asian population compared to Caucasian population.