Telmisartan 40 mg produced a significantly greater mean reduction in diastolic blood pressure compared to enalapril 10 mg (14 vs 9.71 mmHg, p<0.001) at 12 weeks in patients with essential hypertension.
RCT (n=80)
Open-label
Randomized
No
Does telmisartan improve blood pressure reduction and tolerability compared to enalapril in patients with mild to moderate essential hypertension?
Telmisartan provides superior diastolic blood pressure reduction and eliminates the risk of dry cough compared to enalapril in patients with mild to moderate essential hypertension.
Absolute Event Rate: 14% vs 9.71%
p-value: p=<0.001
BACKGROUND: Theoretically, angiotensin II receptor blockers (ARBs) have certain advantages over angiotensin-converting enzyme inhibitors, but the contribution of these advantages to the clinical effect of ARBs is not known. OBJECTIVE: To compare the efficacy and tolerability of telmisartan with enalapril in patients of essential hypertension. MATERIALS AND METHODS: Patients of mild to moderate hypertension were randomized to receive either 40 mg of telmisartan or enalapril 10 mg once a day orally for 12 weeks. At each visit, the systolic blood pressure (BP), diastolic BP and heart rate of each patient were recorded. Investigations such as hemogram hemoglobin, total leucocytes count (Hb, TLC), serum creatinine, serum glutamic oxaloacetic transaminase, serum glutamic pyruric transaminase (SGOT, SGPT) random blood sugar and urine examination were performed at baseline and after 12 weeks of the treatment period. RESULTS: The mean reduction in systolic BP in the telmisartan/enalapril group was 26.38 ± 10.98/26.74 ± 8.24 mmHg while the mean reduction in diastolic BP in the telmisartan/enalapril group was 14 ± 2.98/9.71 ± 4.23 mmHg, respectively, at 12 weeks. When the reduction in systolic BP in the two groups was compared, there was no significant difference between the groups (P > 0.05). However, the mean reduction in diastolic BP achieved with telmisartan at 12 weeks was significantly higher (P < 0.001) than that achieved with enalapril after the corresponding period. The overall frequency of adverse-effects was similar. However, in the enalapril group, the incidence of dry cough was higher as compared to that in the telmisartan group (11.43% vs. 0%, respectively; P < 0.05). CONCLUSION: Telmisartan produces a greater reduction in diastolic BP than enalapril and is free from the adverse-effect of dry cough that is commonly encountered with enalapril.
Akat et al. (2010) conducted an RCT in Mild to moderate essential hypertension (n=80). Telmisartan vs. Enalapril 10 mg once daily was evaluated on Change from baseline sitting diastolic blood pressure at 12 weeks (mmHg) (p=<0.001). Telmisartan 40 mg produced a significantly greater mean reduction in diastolic blood pressure compared to enalapril 10 mg (14 vs 9.71 mmHg, p<0.001) at 12 weeks in patients with essential hypertension.