Key result
Telmisartan attenuated autonomic balance more effectively than enalapril in hypertensive patients, decreasing the low frequency/high frequency ratio compared to enalapril.
Why the study?
Does telmisartan improve sympathetic activity indices compared to enalapril in hypertensive patients?
RCT (n=32)
crossover
Does telmisartan improve sympathetic activity indices compared to enalapril in hypertensive patients?
Telmisartan attenuates autonomic balance more effectively than enalapril in hypertensive patients, despite providing similar blood pressure control.
Answers are grounded in this paper and cite their sources.
Telmisartan may be preferred over enalapril when autonomic modulation is prioritized in hypertension; extends evidence for ARB effects beyond equivalent BP reduction.
OBJECTIVE: To compare the effect of ARB and ACE inhibitor on sympathetic activity in 32 hypertensives. DESIGN AND METHODS: After a four-week wash-out period, patients were randomized to four weeks of therapy with enalapril or telmisrtan, with crossover to another drug for another four weeks. Blood pressure (BP), NPY, and catecholamine levels and HRV (frequency analysis) were measured during wash-out, in basal condition, and after postural stimulation test (PST). RESULTS: Both drugs significantly reduced BP and NPY as compared to initial values, while no differences in BP and NPY between drugs were observed. Increase in NPY during PST was significantly higher in the enalapril than in the telmisartan group and during the wash-out period. No differences between enalapril and telmisartan in plasma catecholamines were observed. Telmisartan decreased low frequency/high frequency ratio as compared to initial values and enalapril values. CONCLUSIONS: Despite similar BP control, telmisartan attenuated autonomic balance more effectively than enalapril.
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Lewandowski et al. (2008) conducted an RCT in hypertension (n=32). Telmisartan vs. Enalapril was evaluated on Sympathetic activity (BP, NPY, catecholamine levels, and HRV). Telmisartan attenuated autonomic balance more effectively than enalapril in hypertensive patients, decreasing the low frequency/high frequency ratio compared to enalapril.
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