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Angiotensin II Receptor Blocker (ARB)

Click here for why I feel that Micardis® (telmisartan) should be the first line treatment for hypertension.

Related Topics:

• Hypertension / pulse pressure / hardening of the arteries / angiotensin II receptor blockers (ARBs) / ace inhibitors / alpha blockers / calcium channel blockers / diuretics / beta blockers / Renin Inhibitors /  Vanlev (omapatrilat) / aldosterone blockers / dihydropyridine (DHP) calcium antagonist / first line treatment for hypertension

Popular ARBs:

• Cozaar® (losartan) / Diovan® (valsartan)  Avapro® (irbesartan) / Atacand® (candesartan) / Micardis® (telmisartan) / Benicar (olmesartan)

News & Research:

• Angiotensin Receptor Blockers Are Associated With a Lower Risk of Progression From Mild Cognitive Impairment to Dementia - Hypertension 2022 Jun 29 - "Previous studies found that antihypertensive medications (AHMs) acting on the renin-angiotensin system had the potential to reduce the progression from mild cognitive impairment to dementia ... In patients with hypertension and mild cognitive impairment, angiotensin receptor blockers were associated with a lower risk of progression to dementia compared with ACE inhibitors and other classes of AHMs"
• Long-term use of blood pressure drugs may cause kidney damage, study suggests - Science Daily, 1/12/22 - "the researchers found, long-term use of drugs that inhibit the renin-angiotensin system, such as ACE inhibitors, or angiotensin receptor blockers, have a similar effect. These drugs are widely used for many purposes, including treating high blood pressure, congestive heart failure and heart attacks, as well as to prevent major heart problems. But long-term use of the drugs was associated with hardened kidney vessels in both lab mice and humans, the scientists found"
• Exploring the Effect of Dapagliflozin on Alcoholic Kidney Injury and Renal Interstitial Fibrosis in Rats Based on TIMP-1/MMP-24 Pathway - Evid Based Complement Alternat Med 2021 Oct 21 - "Long-term large-scale alcohol intake can cause kidney tissue damage and fibrotic lesions. The expression of fibrotic cytokines such as TIMP-1 and Smad3 will increase, and the expression of MMP-24 will be decreased. However, dapagliflozin and losartan have certain therapeutic effects on the abovementioned lesions. The mechanism may be downregulating TIMP-1 and Smad3 and upregulating the expression of MMP-24 and other cytokines in the kidney" - See dapagliflozin and losartan at reliablerxpharmacy.com.
• ARBs Equal ACE Inhibitors for Hypertension, but Better Tolerated - Medscape, 7/26/21 - "side effects were notably lower with ARBs" - But does anyone not already know that?
• l -Arginine Can Enhance the Beneficial Effect of Losartan in Patients with Chronic Aortic Regurgitation and Isolated Systolic Hypertension - Int J Angiol 2021 Jun;30(2) - "chronic aortic regurgitation (CAR) and isolated systolic hypertension (ISH) ... Both groups had a significant reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP), left ventricular end-diastolic volume index (LVEDVI), LV end-systolic volume index (LVESVI), LV mass index (LVMI), and LV mean wall stress after 6- and 12-month treatment ( p <0.01 in all comparisons). Both groups had a significant increase in LV ejection fraction and exercise duration after 6- and 12-month treatment ( p < 0.01 in all comparisons). Using multivariate linear regression analysis, only losartan + l -arginine therapy achieved a significantly lower LVESVI (38.89 ± 0.23 mL/m 2 ), LVEDVI (102.3 ± 0.3 mL/m 2 ), LVMI (107.6 ± 0.3 g/m 2 ), SBP (123.5 ± 1.0 mm Hg), and greater exercise duration (7.38 ± 0.02 minutes) than those of the losartan-only treated groups ( p <0.01 in all comparisons). These findings suggest that early co-administrative strategy provides a beneficial approach to favorably influence the natural history of CAR" - See l-arginine products at Amazon.com.
• New benefits from anti-diabetic drug metformin - Science Daily, 4/15/21 - "the anti-diabetic drug metformin significantly prolongs the survival of mice in a model that simulates the pathology of non-diabetic chronic kidney disease (ND-CKD) by ameliorating pathological conditions like reduced kidney function, glomerular damage, inflammation and fibrosis. Metformin's mechanism is different from existing therapeutics which only treat symptoms, such as the blood pressure drug losartan, so the researchers believe that a combination of these medications at low dose will be highly beneficial. ... This research found that the appropriate combination of metformin and losartan significantly improved renal pathology and prolonged survival in a ND-CKD mouse model. This suggests that the old inexpensive drug metformin could become a new inexpensive drug for patients with chronic kidney disease" - See metformin and losartan at ReliableRX.
• Stopping RAS inhibitors tied to worse outcomes in patients with chronic kidney disease - Science Daily, 12/29/20 - "Renin-angiotensin system inhibitors (RAS inhibitors), including both ACE inhibitors (ending in 'pril') and ARBs (ending in 'sartan'), are common medications for the treatment of hypertension, cardiovascular disease, heart failure and CKD ... Small-scale studies have suggested that stopping RAS inhibitors in these patients may improve kidney function and delay the need for kidney replacement therapy ... Comparing morbidity and mortality rates in patients whose treatment was discontinued with those who continued the drug regimen, the researchers found that discontinuing these medications was associated with an eight percent lower risk of requiring kidney replacement therapy ... However, discontinuing was also linked to a thirteen percent higher risk of death at five years, and a twelve percent higher risk of suffering a heart attack or stroke"
• Blood pressure medication improves COVID-19 survival rates, research finds - Science Daily, 8/24/20 - "Covid-19 patients with high blood pressure who were taking ACEi/ARB medications were 0.67 times less likely to have a critical or fatal outcome than those not taking these medications"
• Candesartan May Improve Cognition Independent of Blood Pressure - Medscape, 8/10/20 - "The angiotensin receptor blocker (ARB) candesartan is associated with superior neurocognitive outcomes compared with lisinopril in older adults with hypertension and mild cognitive impairment ... While these findings would fall into hypotheses generation and justify larger trials, ARBs in general, and candesartan in particular, offer an intriguing therapeutic possibility for cognitive disorders in relation to vascular brain injury, and especially when considered cumulatively with prior observational studies ... 176 individuals aged 55 years or older with mild cognitive impairment and hypertension were withdrawn from prior antihypertensive therapy and randomized to candesartan (up to 32 mg) or lisinopril (up to 40 mg) both once daily ... candesartan was superior to lisinopril in terms of the primary outcome of executive function measured by Trail Making Test Part B (effect size = –12.8) ... Candesartan was also superior to lisinopril in terms of the secondary outcome of episodic memory as measured by the Hopkins Verbal Learning Test-Revised delayed recall (effect size = 0.4) and retention (effect size = 5.1) ... MRI results showed that those randomized to candesartan had less white matter lesion accumulation compared with lisinopril (0.2 vs 0.8 mm3)"
• Common hypertension medications may reduce colorectal cancer risk - AHA, 7/6/20 - "those who took hypertension medications such as ACE-i or ARBs had a 22% lower risk of developing colorectal cancer in the subsequent three years"
• ACEI/ARBs Linked With Survival in Hypertensive, Chinese COVID-19 Patients - Medscape, 4/22/20 - "Among patients with hypertension hospitalized with COVID-19, inpatient treatment with ACEI [ACE inhibitor]/ARB [angiotensin receptor blocker] was associated with lower risk of all-cause mortality, compared with ACEI/ARB nonusers, during 28 days of follow-up. While study interpretation needs to consider the potential for residual confounders, it is unlikely that inpatient ACEI/ARB would be associated with an increased risk of mortality"
• Comparative effects of ACE inhibitors and ARBs on response to a physical activity intervention in older adults: results from Lifestyle Interventions for Elders (LIFE) study - J Gerontol A Biol Sci Med Sci. 2019 May 9 - "Participants age 70-89 years were randomized to a physical activity (PA) or health education (HE) intervention. Outcomes included incident and persistent major mobility disability (MMD), injurious falls, Short Physical Performance Battery (SPPB), and gait speed ... Compared to ACEi users, ARB users had 28% lower risk (HR=0.72 [0.60-0.85]) of incident MMD and 35% (HR=0.65 [0.52-0.82]) lower risk of persistent MMD while no interaction between medication use and intervention was observed. Risk of injurious falls and changes in SPPB or gait speed were not different between ARB and ACEi users"
• Sex, Intimacy Improved on Sacubitril/Valsartan in Heart Failure - Medscape, 4/10/18 - "Improvements over 36 months were most pronounced in domains that reflected being able to work, do household chores or recreational activities, climb stairs, and have intimate and sexual relationships."
• Time to Ditch ACE Inhibitors for CVD? - Medscape, 4/5/18 - "There is "little, if any, clinical reason" to use angiotensin-converting enzyme (ACE) inhibitors for the treatment of hypertension or other cardiovascular indications because angiotensin receptor blockers (ARBs) are just as effective with fewer side effects"
• Blood pressure meds could raise your depression risk - CNN, 10/10/16 - "people taking one of two classes of drugs, known beta blockers or calcium channel antagonists, had twice the risk of being admitted into the hospital with a mood disorder, such as severe depression. However, people taking a class of drugs known as angiotensin blockers -- ACE inhibitors -- had a lower risk of developing severe mood disorders, even compared with healthy control groups with no history of hypertension or depression" - Note: It doesn't mention ARB's.  I think they're talking about ACE inhibitors and ARB's as the same with regards to mood.  If you Google 'angiotensin blockers' it brings up ARB's.
• Telmisartan: A multifaceted antihypertension drug - Curr Med Res Opin. 2016 Apr 7:1-9 - "Among various antihypertensive drugs, angiotensin receptor blockers (ARBs) have an established efficacy and safety, making them a favourable choice. However, all ARBs do not share the same qualities. Telmisartan, beyond its inherent favourable effects of the ARB class, has shown some additional promising pleiotropic effects. Indeed, telmisartan has been associated with favourable outcomes regarding glucose metabolism, dyslipidaemia as well as adipose tissue redistribution. As a result, hypertensive patients with multiple CVD comorbidities may have additional benefits when treated with telmisartan"
• Effects of telmisartan on fat distribution: a meta-analysis of randomized controlled trials - Curr Med Res Opin. 2016 Mar 24:1-24 - "The findings suggest that telmisartan affected fat distribution, inducing visceral fat reduction, and thus, could be useful in hypertensive patients with obesity/overweight, metabolic syndrome, or glucose intolerance"
• New class of blood pressure meds as effective as old, analysis shows - Washington Post, 1/4/16 - "The new analysis, published in Mayo Clinic Proceedings on Monday, involves a second look at 106 randomized trials with 254,301 patients that took place after 2000 and shows that during this time period patient outcomes on the two medications were remarkably similar. The one difference they found was that ARBs tend to be better tolerated by patients, meaning that they have fewer side effects or result in fewer adverse events. ACE inhibitors are poorly tolerated by many patients because they can produce a bothersome dry cough, and some end up stopping medication as a result ... The other piece of good news regarding the medications is that ACE inhibitors, as well as many ARBs, are now generic -- meaning that the cost difference is minimal" - I've been pointing that out for years.  See my Telmisartan as a first line treatment page.
• TBI triggers liver to produce protein tied to inflammation; hypertension drug blocks it - Science Daily, 9/21/15 - "in an animal model, brain injury produces an inflammatory response in the blood and body's organs, especially the liver. The liver responds with increased production (up to a thousand-fold) of a protein that ramps up inflammation in the brain, leading to chronic inflammation, nerve cell death and reduced blood flow ... The investigators also discovered that in mice, small doses of telmisartan, a hypertension drug, blocked production of one of the molecules in the protein's biological pathway, leading to substantial reduction in inflammation. The brain can then possibly heal"
• Blood Pressure Meds May Cut Alzheimer’s Risk - WebMD, 9/14/15 - "People with early thinking and memory issues who took an ACE inhibitor or an ARB medication for their high blood pressure were less likely to get Alzheimer’s disease than those on other BP drugs ... A 2009 study also found that people taking ACE inhibitors that were crossing the brain barrier had a 65% lower risk of getting the disease compared to people taking other kinds of BP drugs"
• Atherosclerosis following renal injury is ameliorated by pioglitazone and losartan via macrophage phenotype - Atherosclerosis. 2015 Jul 4 - "Combination of pioglitazone and losartan is more effective in reducing renal injury-induced atherosclerosis than either treatment alone. This benefit reflects mitigation in macrophage cytokine production, enhanced apoptosis, and a shift toward an anti-inflammatory phenotype"
• The impact of angiotensin receptor blockers on arterial stiffness: a meta-analysis - Hypertens Res. 2015 Apr 9 - "Taken together, our findings support the important role of ARB treatment in improving arterial stiffness"
• A meta-analysis of the effects of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers on insulin sensitivity in hypertensive patients without diabetes - Diabetes Res Clin Pract. 2014 Dec - "In patients showing no significant difference in blood pressure control, the comparison between ACEI and ARB showed that the former type of drug more effectively relieved IS in hypertensive patients without diabetes"
• Prevention of metabolic disorders with telmisartan and indapamide in a Chinese population with high-normal blood pressure - Hypertens Res. 2014 Oct 2 - "The acquisition cost for telmisartan was ~1.86 times higher than for indapamide for a similar antihypertensive effect. The intervention for high-normal blood pressure with telmisartan and indapamide appeared to be feasible and reduced the risk of metabolic syndrome. Telmisartan was more effective, whereas indapamide had better pharmacoeconomic benefits"
• Diabetes and CVD risk during angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment in hypertension: a study of 15 990 patients - J Hum Hypertens. 2014 Jun 26 - "the risk of new diabetes onset was lower in the candesartan group (hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.69-0.96, P=0.01) compared with the enalapril group"
• Telmisartan Exerts Sustained Blood Pressure Control and Reduces Blood Pressure Variability in Metabolic Syndrome by Inhibiting Sympathetic Activity - Am J Hypertens. 2014 May 28 - "the magnitudes and durations of BP control differ across ARBs ... Telmisartan exerted a longer-lasting BP-lowering effect and greater attenuation of BP variability in SHRcp than valsartan. Telmisartan decreased low frequency power of systolic BP and increased spontaneous baroreflex gain in SHRcp during both the dark and light periods more than valsartan. Telmisartan reduced 24-hour urinary norepinephrine excretion more than valsartan"
• Examining the Association of Olmesartan and Other Angiotensin Receptor Blockers With Overall and Cause-Specific Mortality - Hypertension. 2014 Feb 10 - "Subjects who began with valsartan had a modest but significantly increased risk of overall mortality (HR, 1.04; 95% CI, 1.02-1.06) compared with losartan. Irbesartan (HR, 0.96; 95% CI, 0.94-0.99), candesartan (HR, 0.95; 95% CI, 0.92-0.99), telmisartan (HR, 0.93; 95% CI, 0.90-0.96), and olmesartan (HR, 0.93; 95% CI, 0.88-0.97) were associated with a slightly lower overall mortality risk than losartan"
• Angiotensin-Converting Enzyme Inhibitor Therapy and Colorectal Cancer Risk - J Natl Cancer Inst. 2014 Jan 15 - "A nested case-control study was conducted using EPIC's General Practice Research Database (1987-2002) ... The adjusted odds ratios (ORs) of CRC were 0.84 (95% confidence interval [CI] = 0.72 to 0.98; P = .03) for or more years of ACE-I/ARB therapy and 0.75 (95% CI = 0.58 to 0.97; P = .03) for 5 or more years of exposure. The strength of this association increased with high-dose exposure (OR = 0.53; 95% CI = 0.35 to 0.79; P = .003 for ≥3 years of high-dose exposure). Among patients receiving antihypertensive medications, the association with long-term therapy was no longer statistically significant for ≥5 years), but the benefit of high-dose therapy remained (OR = 0.59; 95% CI = 0.39 to 0.89; P = .01 for ≥3 years of high-dose exposure)" - Note:  It might be one more reason to support telmisartan as a first line treatment for hypertension.
• Angiotension receptor blockers reduce the risk of dementia - J Hypertens. 2014 Jan 8 - "a population-based cohort study with data from the Taiwan National Health Insurance Research Database. A total of 24 531 matching pairs (1���: 1) of ARB-exposed and non-ARB-exposed patients were included. Each patient was individually tracked from 1997 to 2009 to identify incident cases of dementia (onset in 1999 or later) ... The multivariate-adjusted hazard ratios for dementia, Alzheimer's disease and vascular dementia were 0.54 (95% CI 0.51-0.59), 0.53 (95% CI 0.43-0.64) and 0.63 (95% CI 0.54-0.73) for patients with ARB treatments, respectively. In terms of cumulative dosage, patients with more than 1460 defined daily dose of ARBs had less risk than those patients with less than 1460 defined daily dose (hazard ratio 0.37 vs. 0.61; P < 0.05) ... These results suggest that ARB may be associated with a reduced risk of dementia in high vascular-risk individuals. Patients exposed to ARBs for higher cumulative doses experienced more protection from dementia and the subtypes"
• ACE Inhibitors, ARBs Lower AF Risk in Hypertension - Medscape, 1/8/14 - "Compared with a beta-blocker and diuretic, the use of an ACE inhibitor reduced the incidence of atrial fibrillation 88% and 49%, respectively. There was no reduction in the incidence of atrial fibrillation when those treated with ACE inhibitors were compared with those who received calcium-channel antagonists. When the same analysis was repeated with ARBs, ARB use reduced the risk of atrial fibrillation 90% and 57%, respectively, when compared with beta-blockers and diuretics. Similarly, there was no reduction in risk when ARBs were compared with calcium-channel antagonists ... When the ARB-treated patients were compared with those who received an ACE inhibitor, the risk of atrial fibrillation was reduced 32%. None of the five medication classes tested differed with regard to the risk of stroke"
• ACE + ARB = Adverse Events - Medscape, 12/17/13 - "patients receiving the active drug combination had an excess occurrence of hyperkalemia and acute kidney injury. The hazard ratio for hyperkalemia was 2.8, and for acute kidney injury, it was 1.7. No benefit, excess risk, and the study was stopped early"
• Lowered Cancer Risk With ACE Inhibitors/ARBs: A Population-Based Cohort Study - J Clin Hypertens (Greenwich). 2013 Nov 8 - "Using the Taiwan National Health Insurance Research Database, 297,688 eligible study patients with essential hypertension were identified. According to their antihypertensive prescriptions, the study patients were stratified into an ACE inhibitor group, an ARB group, or a control group ... In the ACE inhibitor group compared with the control group, the hazard ratio was 0.51 (95% confidence interval, 0.39-0.68). In the ARB group compared with the control group, the hazard ratio was 0.8 (95% confidence interval, 0.65-0.97). Regular use of ACE inhibitors/ARBs was not associated with an increased risk of cancer development and was actually found to decrease overall cancer risk in this study"
• ACE Inhibitor and Angiotensin Receptor Blocker Use and Mortality in Patients with Chronic Kidney Disease - J Am Coll Cardiol. 2013 Nov 6 - "A logistic regression analysis was used to calculate the propensity of ACEI/ARB initiation in 141,413 US veterans with non-dialysis CKD previously unexposed to ACEI/ARB treatment ... inverse probability treatment weighing (IPTW) ... ACEI/ARB administration was associated with significantly lower risk of mortality both in the intention-to-treat analysis (HR=0.81; 95%CI: 0.78-0.84, p<0.001) and in the as-treated analysis with IPTW (OR=0.37; 95%CI: 0.34-0.41, p<0.001)"
• Telmisartan Reduces Mortality and Left Ventricular Hypertrophy With Sympathoinhibition in Rats with Hypertension and Heart Failure - Am J Hypertens. 2013 Oct 5 - "telmisartan (TLM) ... reactive oxygen species (ROS) ... rostral ventrolateral medulla (RVLM) ... stroke-prone spontaneously hypertensive rats (SHRSPs) ... candesartan cilexetil (CAN) ... Compared with the control group, TLM improved survival to a greater extent than CAN. At 4 weeks after treatment, ROS in the RVLM and uNE were significantly lower in the TLM-treated group than in the CAN-treated group, despite the similar depressor effects. At 8 weeks after the treatments, LVH and LVEDP were attenuated in the TLM-treated group compared with the CAN-treated group"
• Blood-pressure drug may help improve cancer treatment - Science Daily, 10/1/13 - "the angiotensin inhibitor losartan improved the delivery of chemotherapy drugs and oxygen throughout tumors by increasing blood flow in mouse models of breast and pancreatic cancer ... Unlike anti-angiogenesis drugs, which improve tumor blood flow by repairing the abnormal structure of tumor blood vessels, angiotensin inhibitors open up those vessels by releasing physical forces that are applied to tumor blood vessels when the gel-like matrix surrounding them expands with tumor growth ... In models of breast and pancreatic cancer, treatment with losartan alone had little effect on tumor growth, but combining losartan with standard chemotherapy drugs delayed the growth of tumors and extended survival" - Note:  Telmisartan is in the same class of drugs.
• A meta-analysis of randomized trials of telmisartan versus losartan for reduction of ambulatory blood pressure - Hypertens Res. 2013 Aug 15 - "MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched through July 2012 ... telmisartan therapy appears to reduce ambulatory BP more than losartan therapy in patients with hypertension"
• Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of Memory Study - Neurology. 2013 Aug 2 - "Secondary longitudinal data analysis of the Ginkgo Evaluation of Memory Study in older adults at least 75 years of age with normal cognition (n = 1,928) or MCI (n = 320) over a median 6.1-year period ... Hazard ratio for incident AD dementia among participants with normal cognition was 0.51 in diuretic (95% confidence interval [CI] 0.31-0.82), 0.31 in ARB (95% CI 0.14-0.68), 0.50 in ACE-I (95% CI 0.29-0.83), 0.62 in CCB (95% CI 0.35-1.09), and 0.58 in BB (95% CI 0.36-0.93) users and was not significantly altered when mean systolic blood pressure was above 140 mm Hg" - Note:  Sounds like the ARB's left the others in the dust.  See my telmisartan as a first line treatment page.
• Two Blood Pressure Drugs Linked to Lower Risk of Heart Disease in Diabetics - Science Daily, 7/8/13 - "there is some evidence from small trials that telmisartan has slightly different properties than other angiotensin-receptor blockers and may improve cardiovascular health ... telmisartan and valsartan were associated with a significantly lower risk of hospitalization for heart attack, stroke or heart failure compared with other angiotensin-receptor blockers ... at clinically attainable serum concentrations, telmisartan is unique among these drugs in its ability to structurally interact with and activate the PPARg receptor, a ligand-activated transcription factor that regulates lipid metabolism and insulin sensitivity"
• Telmisartan modulates mitochondrial function in vascular smooth muscle cells - Hypertens Res. 2012 Dec 20 - "These findings demonstrate that telmisartan can have significant effects on mitochondrial metabolism in VSMC that are potentially relevant to the pathogenesis of cardiovascular disease and that involve more than just angiotensin receptor blockade and activation of PPARγ"
• Losartan Improves Erectile Dysfunction in Diabetic Patients - Medscape, 12/3/12 - "In this study, we found that diabetic patients suffering from ED were responsive to the losartan treatment. The IIEF-5 scores, the percentage of positive answers to the SEP-2, SEP-3 and GAQ after treatment are all significantly increased as compared with baseline and the end point of control groups. The analysis of our study also indicated that losartan worked better in mild and moderate ED than severe cases. It is consistent with our previous studies, which shows that losartan can downregulate the local expression of AT1 and Ang II, but it cannot elevate the reduced smooth muscle/collagen ratio in diabetic rats [7,8] We believe that the losartan may not completely reverse the severe damaged penile tissues due to diabetes" - Note:  It says that's the first study in diabetics but I've read several studies over the years supporting losartan and ED.  It would seem that it would extend to the entire ARB class of antihypertensives but I haven't seen studies on that.  See losartan (Cozaar) OffshoreRx1.com.
• Losartan improves erectile dysfunction in diabetic patients: a clinical trial - Int J Impot Res. 2012 Aug 30 - "Erectile function was assessed by International Index of Erectile Function (IIEF-5) questionnaire, the percentage of positive responses to sexual encounter profile questions 2 (SEP2), 3 (SEP3) and the global assessment question (GAQ). Losartan or tadalafil or losartan plus tadalafil significantly improved the mean IIEF-5 scores, the percentage of successful penetrations (SEP2), the successful intercourse completions (SEP3) and GAQ (P<0.05). The combination of losartan and tadalafil is more effective than the single-use of losartan or tadalafil (P<0.05). The patients with moderate and mild ED had better response rates to losartan than patients with severe ED"
• ARBs May Curb Amyloid Deposition in the Brain - Medscape, 9/13/12 - "In 2011, a large British study confirmed this result, finding a 53% lower risk for AD in older adults prescribed an ARB compared with those prescribed other antihypertensive agents ... until now, the mechanism for the apparent protective effect of ARBs on the brain was unclear ... Compared with use of other antihypertensive medications, use of ARBs was associated with a 32% to 35% lower likelihood of AD diagnosis, depending on the criteria used. This was also true when the researchers compared patients treated with ARBs vs untreated patients ... Patients treated with ARBs, with or without a diagnosis of AD, also had significantly less amyloid deposition than untreated patients and those treated with non-ARB antihypertensive medications"
• Losartan improves erectile dysfunction in diabetic patients: a clinical trial - Int J Impot Res. 2012 Aug 30 - "A total of 124 diabetic patients with ED were included in this study and treated with losartan or tadalafil or losartan plus tadalafil or watch for waiting as control for 12 weeks ... Losartan or tadalafil or losartan plus tadalafil significantly improved the mean IIEF-5 scores ... The combination of losartan and tadalafil is more effective than the single-use of losartan or tadalafil" - See losartan and tadalafil at OffshoreRx1.com.
• Telmisartan at 80 mg/Day Increases High-Molecular-Weight Adiponectin Levels and Improves Insulin Resistance in Diabetic Patients - Adv Ther. 2012 Jul 20 - "patients with type 2 diabetes and hypertension with poor control of blood pressure by 40 mg/day telmisartan were randomly assigned into the telmisartan 80 mg/day (Tel80) group (dose increase from 40 to 80 mg/day) or the telmisartan 40 mg + amlodipine 5 mg (Tel40 + Aml5) group ... Although the antihypertensive effects of the two doses of telmisartan were similar, a significant increase in HMW adiponectin levels was noted only in the Tel80 group"
• Blood pressure drugs linked with lower PTSD symptoms - Science Daily, 5/1/12 - "These data come from an observational study, not a randomized clinical trial, so it is important to limit our interpretation until larger, placebo-control, double-blinded trials can be performed ... Patients taking ACE inhibitors or ARBs had an approximately 30 percent decrease in PTSD symptom scores, but no significant differences were apparent for those taking other blood pressure medications, including beta-blockers, calcium channel blockers, and diuretics. In particular, individuals taking ACE inhibitors or ARBs tended to have lower levels of hyperarousal and intrusive thoughts" - See telmisartan or ramipril at OffshoreRx1.com.
• More Evidence That ARBs Have Cognitive Benefits - Medscape, 3/23/12 - "After stopping their antihypertensive medications, the patients were randomly assigned to the ARB candesartan (n = 20), the angiotensin-converting enzyme inhibitor (ACEI) lisinopril (n = 18), or the diuretic hydrochlorothiazide (n = 15) ... After adjustment for age and baseline score on the Mini-Mental State Examination, patients taking candesartan showed the greatest improvements on tests assessing executive function ... Our findings further support observational data showing that ARB use is associated with lower risk of dementia and Alzheimer disease compared with the use of ACEIs or other antihypertensives ... As reported previously by Medscape Medical News, Dr. Kehoe and colleagues recently published a study showing a 53% lower risk for Alzheimer's disease in older adults prescribed an ARB compared with those prescribed other antihypertensive agents"
• Adiponectin elevation by telmisartan ameliorates ISCHEMIC MYOCARDIUM IN Zucker Diabetic Fatty rats with metabolic syndrome - Diabetes Obes Metab. 2011 Nov 3 - "myocardial ischemia/reperfusion (I/R) injury ... Telmisartan reduced the extension of the infarct size in a dose-dependent fashion and decreased the levels of plasma troponin I, a specific marker of myocardial damage. Telmisartan also caused a dose-dependent increase in adiponectin both in plasma and cardiac tissue of infarcted ZDF rats. These levels were minimally increased (p<0.05 vs vehicle) by telmisartan 7 mg/kg/day and reached the maximum values with the highest dose of 12 mg/kg/day (p<0.01 vs vehicle). In contrast, within the infarcted tissue telmisartan decreased the expression of markers of inflammation such as the transcription factor NF-κB, the toll-like receptors TLR2 and TLR4 as well as TNF-α cytokine. Nitrosative stress was maximal in vehicle-treated infarcted hearts as evidenced by increased expression of iNOS, which was almost abolished after treatement with telmisartan. Conclusions: Treatment of ZDF rats for three weeks with telmisartan, a dual angiotensin II receptor antagonist and partial PPAR-γ receptor agonist, resulted in a significant reduction of myocardial damage induced by I/R and was assocciated with increased adiponectin and a decrease in inflammatory markers"
• Fuel to the Fire or Flame Retardant? More on ARB Use/Cancer - Medscape, 10/6/11 - "use of angiotensin-receptor blockers (ARBs) or ACE inhibitors is not associated with a significantly increased risk of cancer, according to the latest meta-analysis to address this controversy [1]. The findings add yet another wrinkle in a series of published studies attempting to address the cancer issue with the antihypertensive medications, with some studies suggesting there is a cancer link while others finding none ... How Did the Controversy Begin? ..."
• Systematic review of the effect of telmisartan on insulin sensitivity in hypertensive patients with insulin resistance or diabetes - J Clin Pharm Ther. 2011 Aug 17 - "Telmisartan is an angiotensin receptor blocker (ARB) originally developed for the treatment of hypertension. It can also partially activate peroxisome proliferator-activated receptor (PPAR)-γ, which may improve insulin sensitivity. This effect may prove useful in hypertensive patients with insulin resistance or diabetes mellitus. Such activity is more marked than that observed with other ARBs ... Eight trials involving a total of 763 patients met the inclusion criteria. Telmisartan was superior to other ARBs in reducing FPG level (mean difference, -8.63 mg/dL; 95% CI -12.29 mg/dL to -4.98���mg/dL; P < 0.00001) and increasing adiponectin level (mean difference, 0.93 μg/dL; 95% CI 0.28 μg/dL to 1.59 μg/dL; P = 0.005). At 80 mg dose, telmisartan may reduce FPI level and HOMA-IR. What is new and Conclusions: The available evidence suggests a beneficial effect of telmisartan in improving insulin sensitivity in hypertensive patients with insulin resistance or diabetes as demonstrated by the decrease in FPG and increase in adiponectin levels. The effect in decreasing FPG was greater with 80 mg dose than with the 40 mg dose. FPI and insulin resistance may be improved with 80 mg of telmisartan" - See telmisartan at  OffshoreRx1.com.
• Prophylactic treatment with telmisartan induces tissue-specific gene modulation favoring normal glucose homeostasis in Cohen-Rosenthal diabetic hypertensive rats - Metabolism. 2011 Aug 4 - "Telmisartan blunted the development of hypertension, insulin resistance, and diabetes in prediabetic Cohen-Rosenthal diabetic hypertensive rats through pleiotropic activity, involving specific gene regulation of target organs"
• Reduction of circulating superoxide dismutase activity in type 2 diabetic patients with microalbuminuria and its modulation by telmisartan therapy - Hypertens Res. 2011 Aug 4 - "Interestingly, the telmisartan treatment not only reduced the circulating levels of two oxidative stress markers, 8-hydroxy-2'-deoxyguanosine (8-OHdG) and nitrotyrosine (NT), but also enhanced serum SOD activity. Notably, a significant correlation was observed between the increase in serum SOD activity and the reduction in albuminuria. We further compared the anti-oxidative effect of telmisartan with that of losartan, another member of the ARB class, by implementing an 8-week interval crossover treatment with these ARBs in another 12 microalbuminuric type 2 diabetic patients. The patients showed higher serum SOD activity, and lower circulating levels of 8-OHdG and NT, during treatment with telmisartan than with losartan. These results suggest that telmisartan has a more potent antioxidative effect through its ability to enhance SOD activity in type 2 diabetic patients with microalbuminuria" - See telmisartan at OffshoreRx1.com.
• Effects of telmisartan and losartan on cardiovascular protection in Japanese hypertensive patients - Hypertens Res. 2011 Jul 28 - "A total of 58 patients were enrolled in the present trial and the follow-up period was 1 year. There were no significant differences in blood pressure (BP) levels between the telmisartan group and the losartan group throughout the trial. The percentage of the patients treated with ARB monotherapy was significantly higher in the telmisartan group compared with the losartan group. In addition, the progression of intima-media thickness of common carotid artery was significantly inhibited in the telmisartan group compared with the losartan group. Neither group experienced significant changes in cardiac function and LV mass index. There were no differences between the groups with respect to changes in surrogate markers such as serum adiponectin, creatinine, homeostasis model assessment index, plasminogen activator inhibitor-1 and high sensitivity C-reactive protein. Although BP levels were equal and well controlled in both groups, telmisartan showed more protective vascular effects than losartan" - See my telmisartan as a first line treatment page and telmisartan at OffshoreRx1.com.
• Influence of telmisartan on insulin response after glucose loading in obese patients with hypertension: ARB Trial of hypertension in obese patients with hyperinsulinemia assessed by oral glucose tolerance test (ATHLETE) - Adv Ther. 2011 Jul 6 - "In patients with hypertension and obesity showing insulin resistance, treatment with telmisartan significantly improved the hyperinsulin response to glucose loading. Telmisartan may therefore be beneficial in these patients" - See telmisartan at OffshoreRx1.com.
• Telmisartan for the management of patients at high cardiovascular risk - Curr Med Res Opin. 2011 Jun 30 - "To date, telmisartan is the only ARB indicated to reduce CV morbidity in a broad CV high-risk population"
• Endoplasmic Reticulum Stress Caused by Left Ventricular Hypertrophy in Rats: Effects of Telmisartan - Am J Med Sci. 2011 Jun 2 - "Studies have revealed that excessive endoplasmic reticulum (ER) stress leads to apoptosis. Although cardiomyocytes apoptosis contributes to the transition from left ventricular hypertrophy (LVH) to heart failure, it is unknown whether ER stress participates in the pathologic process. The authors first induced coarctation of the abdominal aorta in rats to induce LVH and then investigated the effect of telmisartan on the resulting ER stress ... Telmisartan significantly reduced LVH and interstitial fibrosis and improved left ventricular function compared with AAC alone. Cardiac markers of ER stress such as GRP78, C/EBP homologous protein, caspase-12 and phospho c-Jun NH2-terminal kinase were significantly increased in rats with AAC, and telmisartan significantly blunted these changes. Rats that received both telmisartan and AAC had less apoptosis due to ER stress"
• FDA Review Concludes: No Cancer Risk With ARBs - Medscape, 6/2/11 - "An FDA review launched in the wake of a controversial 2010 meta-analysis by DrIlkeSipahi (University Hospitals Case Medical Center, Cleveland, OH) et al [1] suggesting an increased risk of cancer among patients taking angiotensin-receptor blockers (ARBs) has concluded that the drugs do not pose a cancer risk to patients"
• Lower Diabetes Incidence in Patients Treated With ACEIs and ARBs - Medscape, 5/25/11 - "Over an average follow-up of 4.0 +/- 1.0 years, there were 1284 (8.5%) incident cases of diabetes in active-treated and 1411 (9.3%) cases in placebo-treated patients in the ACE inhibitor trials, and there were 2330 (12.4%) cases in active-treated and 2669 (14.2%) cases in placebo-treated patients in the ARB trials. Overall, active therapy reduced diabetes incidence compared with placebo (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.8-0.9; P < .01). ARBs significantly reduced diabetes incidence (OR, 0.8; CI, 0.8-0.9; P < .01). Incidence was also lower for ACEIs (OR, 0.8; CI, 0.7-1.0) but was only marginally significant (P = .07)"
• Use of Angiotensin Receptor Blockers and the Risk of Cancer - Circulation. 2011 Apr 11 - "Among 107 466 ARB users, 3954 cases of cancer were detected during 312 753 person-years of follow-up compared with 6214 cases during 435 207 person-years of follow-up in 209 692 angiotensin-converting enzyme inhibitor users (adjusted rate ratio, 0.99; 95% confidence interval, 0.95 to 1.03). Cancer risk did not increase with increasing duration of ARB exposure (increase in rate ratio per year, 0.99; 95% confidence interval, 0.99 to 1.00,) and was similar across individual ARBs. In subgroup analyses, there was a significant association between ARB use and cancer of male genital organs (rate ratio, 1.15; 95% confidence interval, 1.02 to 1.28), but no significantly increased risk of any of the other 15 cancer subgroups, including lung cancer (rate ratio, 0.92; 95% confidence interval, 0.82 to 1.02). For cancer mortality, the rate ratio was 0.77 (95% confidence interval, 0.72 to 0.82). Conclusion- In this large nationwide cohort, use of ARBs was not significantly associated with increased risk of incident cancer overall or of lung cancer" - Note:  I'm not clear on the cutoff for what they consider significant.  It seems like 15% can be insignificant in one study and significant in another study.  Compared to the nearly 5 times increased risk of esophageal adenocarcinoma from processed meat, 15% increase cancer of male genital organs from ARB's seems negligible plus I'm not aware that that form of cancer is common.  Bottom line, ARB users had a 23% overall less chance of dying.  I'd be much more worried about processed meat.
• Blood pressure drug shows some muscle: Researchers discover losartan protects against loss of old or damaged muscle - Science Daily, 5/11/11 - "Using geriatric mice, a Johns Hopkins research team has shown that losartan, a commonly used blood pressure drug, not only improves regeneration of injured muscle but also protects against its wasting away from inactivity ... To investigate losartan's role in muscle injury regeneration in the context of aging, the Hopkins team worked with 40 mice which, at 21-months old, were considered geriatric. After treating half of those animals for a week to water laced with losartan, they injected a chemical toxin into all the animals' shin muscles. The researchers examined the stained muscle tissue under a microscope at four days and again at 19 days, looking for signs of regeneration: small fibers with larger-than-usual nuclei. After four days, they saw no difference in the number of regenerating fibers between the losartan-treated mice and those not treated. However, after 19 days, the losartan-treated mice had about 10 to 15 percent of scar tissue formation compared with 30 to 40 percent of scar tissue formation in those not treated ... Again, using 21-month-old mice, half treated with losartan and half not, the team this time clipped the hind right foot of the mice to their knees, immobilizing just the shin muscles; otherwise, the mice were normally active ... After 21 days, the animals' shin muscles were weighed and compared under a microscope. The animals not treated with losartan lost 20 percent of the mass of their immobilized shin muscles. However, the losartan-treated animals lost virtually no mass, according to Tyesha Burks, a graduate student of Human Genetics, Johns Hopkins University School of Medicine ... "When we saw that the loss of muscle fibers was completely prevented by losartan therapy, it was quite mind-blowing," Cohn says" - Note:  Losartan is an ARB as is telmisartan which may be superior.  Maybe future studies will tell whether telmisartan has the same muscle loss prevention characteristics.  I'm guessing it will.
• Value of Angiotensin receptor blocker therapy in diabetes - J Clin Hypertens (Greenwich). 2011 Apr;13(4):290-5 - "There are more clinical trials investigating angiotensin receptor blockers (ARBs) in diabetes than any other drug class, ranging from early "prevention" trials to the treatment of individuals with advanced organ damage. In its earliest manifestations, visceral adiposity predisposes to hypertension and hyperglycemia (metabolic syndrome). In these individuals, ARB therapy delays the progression to chronic hypertension and may also delay the progression to overt diabetes. Based on the increased cardiovascular disease risk of the metabolic syndrome, which is similar to stage 1 hypertension, both lifestyle modification and ARB therapy are justifiable. ARB therapy has also been found to delay the onset of microalbuminuria and retinopathy. In established diabetic nephropathy, ARB therapy is recommended as a standard alternative to angiotensin-converting enzyme inhibition to reduce macroalbuminuria and delay the progression to end-stage disease. Finally, large trials in ischemic heart disease, heart failure, and stroke have demonstrated clear benefits of ARB therapy. Because ARBs have side effect rates equal to placebo and far lower than any other antihypertensive drug class, the benefit/risk ratio is highly favorable across the entire spectrum of diabetic disease. Thus, ARB therapy is a highly attractive alternative for individuals at any stage of diabetes and with any pattern of complications"
• Telmisartan Provides Better Renal Protection Than Valsartan in a Rat Model of Metabolic Syndrome - Am J Hypertens. 2011 Mar 17 - "spontaneously hypertensive rats (SHR) ... SHR were fed either normal (SHR-NF, 7% fat) or high fat (SHR-HF, 36% fat) diet and treated with an ARB for 10 weeks.ResultsBlood pressure was similar between SHR-NF (190 +/- 3 mm Hg) and SHR-HF (192 +/- 4 mm Hg) at the end of the 10 week period. Telmisartan and valsartan decreased blood pressure to similar extents in SHR-NF and SHR-HF groups. Body weight was significantly higher in SHR-HF (368 +/- 5 g) compared to SHR-NF (328 +/- 7 g). Telmisartan but not valsartan significantly reduced the body weight gain in SHR-HF. Telmisartan was also more effective than valsartan in improving glycemic and lipid status in SHR-HF. Monocyte chemoattractant protein-1 (MCP-1), an inflammatory marker, was higher in SHR-HF (24 +/- 2 ng/d) compared to SHR-NF (14 +/- 5 ng/d). Telmisartan reduced MCP-1 excretion in both SHR-HF and SHR-NF to a greater extent than valsartan. An indicator of renal injury, urinary albumin excretion increased to 85 +/- 8 mg/d in SHR-HF compared to 54 +/- 9 mg/d in SHR-NF. Telmisartan (23 +/- 5 mg/d) was more effective than valsartan (45 +/- 3 mg/d) in lowering urinary albumin excretion in SHR-HF. Moreover, telmisartan reduced glomerular damage to a greater extent than valsartan in the SHR-HF.ConclusionsCollectively, our data demonstrate that telmisartan was more effective than valsartan in reducing body weight gain, renal inflammation, and renal injury in a rat model of cardiometabolic syndrome"
• Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers and Diabetes: A Meta-Analysis of Placebo-Controlled Clinical Trials - Am J Hypertens. 2011 Feb 17 - "new onset diabetes (NOD) ... Over an average follow-up of 4.0 +/- 1.0 years, there were 1,284/15,142 (8.5%) cases of NOD in active-treated and 1,411/15,130 (9.3%) cases in placebo-treated patients in the ACE inhibitor trials, and 2,330/18,756 (12.4%) cases in active-treated and 2,669/18,800 (14.2%) cases in placebo-treated patients in the ARB trials. Overall, active therapy reduced NOD compared to placebo (odds ratio (OR) 95%, confidence interval (CI): 0.8 (0.8-0.9); P < 0.01). Both ACE inhibitors (OR 95%, CI: 0.8 (0.7-1.0); P = 0.07) and ARBs (OR 95%, CI: 0.8 (0.8-0.9); P < 0.01) reduced NOD as compared to placebo. Active treatment reduced CV mortality (OR 95%, CI: 0.9 (0.8-1.0); P < 0.01) and had a favorable impact on non-CV mortality (OR 95%, CI: 0.7 (0.9-1.0); P = 0.2) as compared to placebo.ConclusionsOur findings demonstrated that ACE inhibitors or ARBs should be preferred in patients with clinical conditions that may increase risk of NOD, since these drugs reduced NOD incidence. In addition, these drugs have favorable effects on CV and non-CV mortality in high CV risk patients"
• Inhibition of intestinal cholesterol absorption might explain cholesterol-lowering effect of telmisartan - J Clin Pharm Ther. 2011 Feb;36(1):103-10 - "Recently, it has been demonstrated that telmisartan also lowers the levels of total cholesterol and low-density lipoprotein (LDL) cholesterol levels ... Our results suggest that the cholesterol-lowering effect of telmisartan might be caused by inhibition of cholesterol absorption, whereas that of statins is by inhibition of cholesterol synthesis. If confirmed, co-treatment with the two agents may be useful for synergistically lowering cholesterol in hypertensive patients"
• Clinical effectiveness of telmisartan alone or in combination therapy for controlling blood pressure and vascular risk in the elderly - Clin Interv Aging. 2010 Dec 3;5:403-16 - "Two large clinical trials, ONTARGET (Ongoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomized AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular disease) have assessed the cardioprotective and antidiabetic effects of telmisartan. The collective data suggest that telmisartan is a promising drug for controlling hypertension and reducing vascular risk in high-risk elderly patients with new-onset diabetes" - Also see my telmisartan as a fist line treatment page.
• Effects of telmisartan added to Angiotensin-converting enzyme inhibitors on mortality and morbidity in hemodialysis patients with chronic heart failure a double-blind, placebo-controlled trial - J Am Coll Cardiol. 2010 Nov 16;56(21):1701-8 - "In hemodialysis patients, CHF is responsible for a high mortality rate ... At 3 years, telmisartan significantly reduced all-cause mortality (35.1% vs. 54.4%; p < 0.001), cardiovascular death (30.3% vs. 43.7%; p < 0.001), and hospital admission for CHF (33.9% vs. 55.1%; p < 0.0001). With Cox proportional hazards analysis, telmisartan was an independent determinant of all-cause mortality (hazard ratio [HR]: 0.51; 95% confidence interval [CI]: 0.32 to 0.82; p < 0.01), cardiovascular mortality (HR: 0.42; 95% CI: 0.38 to 0.61; p < 0.0001), and hospital stay for deterioration of heart failure (HR: 0.38; 95% CI: 0.19 to 0.51; p < 0.0001). Adverse effects, mainly hypotension, occurred in 16.3% of the telmisartan group versus 10.7% in the placebo group" - Note:  It makes me wonder if similar effects on mortality might be seen in people without kidney disease.  See my telmisartan as a first line treatment page.
• ARBS and Cancer -- Are We Looking at Junk Science? - Medscape, 6/28/10 - Good video.
• Would VALUE Cancer Data Negate Findings of Report? - Medscape, 6/25/10 - "from a pathophysiological viewpoint, the finding in the meta-analysis of increased cancer with ARBs in such a short time period--two to four years--does not make sense: it takes around 10 years to develop lung and other cancers from smoking, the hypertension doctors argue. Some said they had discussed the findings with oncologists, who think the concept is farfetched"
• Popular blood pressure pills linked to cancer - MSNBC, 6/13/10 - "experts found a link between people taking medicines known as angiotensin-receptor blockers ... one extra cancer case will occur for every 105 people taking the medications for about four years ... The maker of the most-used drug in the study ... it had "internal safety data" contradicting the Lancet study. According to studies run by the pharmaceutical, there was no link between increased cancer risk and Micardis ... Scientists aren't sure why ARBs might raise the possibility of developing cancer, though some animal studies suggest the medications help produce new blood vessels, which would speed tumor growth" - Note:  New blood vessels can be a good thing like with heart disease (2) and PAD and increased endurance so it may be sacrificing one thing for another.
• Telmisartan Prevents Weight Gain and Obesity Through Activation of Peroxisome Proliferator-Activated Receptor-{delta}-Dependent Pathways - Hypertension. 2010 Feb 22 - "long-term administration of telmisartan significantly reduced visceral fat and prevented high-fat diet-induced obesity in wild-type mice and hypertensive rats but not in PPAR-delta knockout mice. Administration of telmisartan did not influence food intake in mice ... We conclude that telmisartan prevents adipogenesis and weight gain through activation of PPAR-delta-dependent lipolytic pathways and energy uncoupling in several tissues" - See telmisartan at OffshoreRx1.com.
• Telmisartan: a Different Angiotensin II Receptor Blocker Protecting a Different Population? - J Int Med Res. 2009;37(6):1662-1679 - "Telmisartan has a unique profile among ARBs, with a high affinity for the angiotensin II type 1 receptor, a long duration of receptor binding, a high lipophilicity and a long plasma half life. This leads to sustained and powerful blood pressure lowering when compared with the first marketed ARBs, such as losartan and valsartan. Some pharmacological properties of telmisartan clearly distinguish it from other members of the ARB class and may contribute to the clinical effects seen with telmisartan. A class effect for ARBs cannot be assumed. To date, telmisartan is the only ARB that has been shown to reduce cardiovascular risk in at-risk cardiovascular patients" - Click here for reasons to consider telmisartan as a first line treatment for hypertension.  See telmisartan at OffshoreRx1.com.
• Telmisartan ameliorates hyperglycemia and metabolic profile in nonobese Cohen-Rosenthal diabetic hypertensive rats via peroxisome proliferator activator receptor-gamma activation - Metabolism. 2010 Jan 12 - "adiponectin was significantly (60%, P < .01) increased by telmisartan ... The telmisartan-induced increase in adiponectin was most probably associated with a decrease in glucose and tumor necrosis factor alpha levels. Therefore, in addition to its hypotensive effect, telmisartan demonstrated beneficial thiazolidinedione-like effects"
• Hypertension Drugs May Cut Alzheimer's Risk - WebMD, 1/12/10 - "The patients taking an angiotensin receptor blocker had a 19% lower risk of developing dementia compared to those taking lisinopril and a 24% lower risk compared to use of other blood pressure/heart medications. People taking both an ACE inhibitor and an angiotensin receptor blocker, which both target the angiotensin system, had a 46% lower risk of dementia compared with those taking other medications"
• Neuroendocrine characterization and anorexigenic effects of telmisartan in diet- and glitazone-induced weight gain - Metabolism. 2009 Sep 28 - "Telmisartan prevents weight gain and decreases food intake in models of obesity and in glitazone-treated rodents" - Note:  That might be another reason for using telmisartan as a first line treatment for hypertension.
• Valsartan Reduces Morbidity And Mortality In Japanese Patients With High Risk Hypertension: Results From The KYOTO HEART Study - Science Daily, 9/1/09
• Cognitive Deficit in Amyloid-{beta}-Injected Mice Was Improved by Pretreatment With a Low Dose of Telmisartan Partly Because of Peroxisome Proliferator-Activated Receptor-{gamma} Activation - Hypertension. 2009 Jul 27 - "Taken together, our findings suggest that even a low dose of telmisartan had a preventive effect on cognitive decline in an Alzheimer disease mouse model, partly because of PPAR-gamma activation"
• Achieving blood pressure goals: should angiotensin II receptor blockers become first-line treatment in hypertension? - J Hypertens. 2009 Jul;27 Suppl 5:S9-14 - "Recently, the ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) study established that telmisartan reduces morbidity and mortality in a broad cross-section of patients at high risk for heart and vascular events, to an extent similar to that of the angiotensin-converting enzyme inhibitor ramipril. In addition, ONTARGET demonstrated that telmisartan is somewhat better tolerated than ramipril. Attributes such as effective blood pressure lowering, tolerability and convincing outcomes data mean that ARBs satisfy the requirements for first-line antihypertensive agents"
• Effects of angiotensin II receptor blockers on diabetic nephropathy - J Hypertens. 2009 Jul;27 Suppl 5:S15-21 - "Key beneficial effects of ARBs and ACE inhibitors throughout the kidney disease continuum are primarily explained by blood pressure lowering effects and partially by their direct blockade of angiotensin II. Recent studies have shown that telmisartan, an ARB with high lipophilicity and the longest half-life compared with other ARBs, provides benefits on markers of cardiovascular risk, that is, microalbuminuria and slowing of early-stage nephropathy"
• Clinical evidence from ONTARGET: the value of an angiotensin II receptor blocker and an angiotensin-converting enzyme inhibitor - J Hypertens. 2009 Jul;27 Suppl 5:S23-9 - "Telmisartan was better tolerated than ramipril in this high-risk population: notably, the incidence of cough and angioedema was significantly lower with telmisartan alone. Thus, telmisartan provides comparable efficacy to ramipril with less adverse events, which may encourage patient compliance"
• Liver Disease 'Shrunk' By Blood-pressure Drug - Science Daily, 6/2/09 - "analysed a small clinical trial of losartan, a drug normally prescribed for hypertension, on 14 patients in Spain, who had Hepatitis C ... Half of the patients in the trial saw the scars in their liver shrink allowing the organ to repair itself ... Researchers believe that the drug blocks the signalling pathway so that the liver myofibroblasts die, removing the source of scar tissue. As the scar tissue breaks up, the damaged area of the liver is repaired by the body"
• Breast Cancer Gene Can Be Blocked By Blood Pressure Drug - Science Daily, 6/1/09 - "The gene, called AGTR1, caused normal breast cells to behave like cancer cells. This behavior was reversed by treatment with the blood pressure drug losartan. Tumors in mice that expressed AGTR1 shrunk by 30 percent eight weeks after treatment with losartan"
• Telmisartan Increases the Permeability of Endothelial Cells through Zonula Occludens-1 - Biol Pharm Bull. 2009 Mar;32(3):416-20 - "telmisartan but not valsartan downregulated ZO-1 mRNA and protein levels, disrupted the distribution of ZO-1 in cultured endothelial cells, and increased the permeability of endothelial cells in a dose-dependent manner ... telmisartan disrupts the continuous pericellular distribution of ZO-1, downregulates the expression of ZO-1 in endothelial cells, and increases the permeability of endothelial cells at least partly through PI3K and the peroxisome proliferator-activated receptor gamma-dependent pathway"
• Antihypertensive efficacy of telmisartan vs ramipril over the 24-h dosing period, including the critical early morning hours: a pooled analysis of the PRISMA I and II randomized trials - J Hum Hypertens. 2009 Feb 19 - "The adjusted mean treatment differences in the last 6-h mean ambulatory SBP/DBP were -5.8/-4.2 mm Hg after 8 weeks and -4.1/-3.0 mm Hg after 14 weeks, in favour of telmisartan (P<0.0001 for all four comparisons). Secondary end point results, including the mean 24-h ambulatory BP monitoring, day- and night-time BP and 24-h BP load, also significantly favoured telmisartan (P<0.0001). Both treatments were well tolerated; adverse events, including cough, were less common with telmisartan. These findings suggest that telmisartan is more effective than ramipril throughout the 24-h period and during the EMBPS; this may be attributable to telmisartan's long duration of effect, which is sustained throughout the 24-h dosing period" - Click here for why I feel telmisartan should be a first line treatment for hypertension. See telmisartan at OffshoreRx1.com.
• Telmisartan induces proliferation of human endothelial progenitor cells via PPARgamma-dependent PI3K/Akt pathway - Atherosclerosis. 2008 Dec 31 - "since endothelial progenitor cells (EPCs) are thought to play a critical role in ischemic diseases, we investigated effects of telmisartan on proliferation of EPCs ... These findings suggest that telmisartan might contribute to endothelial integrity and vasculogenesis in ischemic regions by increasing numbers of EPCs"
• Hypertension Drug Dramatically Reduces Proteinuria In Kidney Disease Patients - Science Daily, 2/22/09 - "patients taking 128 mg of candesartan experienced more than a 33% reduction in proteinuria compared with those receiving 16 mg candesartan by the end of the study. This reduction was in addition to the reduction in proteinuria that the patients would have had when they first started taking candesartan at 16 mg daily"
• Telmisartan improves insulin resistance in high renin nonmodulating salt-sensitive hypertensives - J Hypertens. 2008 Dec;26(12):2393-8 - "Nonmodulating (NMHT) is a high-renin subtype of salt sensitive hypertension, which additionally develops insulin resistance and oxidative stress. Conversely, modulating hypertensives (MHT) normally regulates renal hemodynamics after high sodium intake without metabolic impairment ... In NMHT, telmisartan, after 3 months treatment, significantly reduced fasting and 120 min insulinemia (fasting: 8.4 +/- 2, 120 min: 25 +/- 10 muU%; P < 0.01) compared either to basal values or ramipril treatment. Similarly, only in NMHT, compared with basal values and ramipril treatment, telmisartan improved the HOMA-IR index in both MHT (2.76 +/- 0.16 to 2.24 +/- 0.18, P < 0.05) and NMHT (from: 4.4 +/- 1 to 2.3 +/- 0.7) and triglyceride plasma levels (MHT: from 139 +/- 1.85 to 122 +/- 2.4 mg%, P < 0.05; NMHT: from: 223 +/- 12 to 146 +/- 10 mg%, P < 0.01). Finally, highly sensitive C-protein-reactive protein values were higher in NMHT (0.33 +/- 0.07 mg.dl) than in MHT (0.14 +/- 0.06 mg.dl; P < 0.01). Both treatments reduced highly sensitive C-protein-reactive protein in NMHT. (ramipril from 0.32 +/- 0.05 mg.dl to 0.26 +/- 0.06 m.dl (P < 0.05) and telmisartan from 0.34 +/- 0.05+/- to 0.20 +/- 0.05 mg.dl (P < 0.01). CONCLUSION: Our data suggest that the improvement of the insulin sensitivity by telmisartan, instead of a similar effect on blood pressure shown by both drugs, could be ascribed to the PPAR agonistic action of telmisartan. This opens an interesting therapeutic approach for patients with hypertension and altered glycemic metabolism"
• Telmisartan prevents aneurysm progression in the rat by inhibiting proteolysis, apoptosis and inflammation - J Hypertens. 2008 Dec;26(12):2361-73 - "The angiotensin II type 1 receptor antagonist, telmisartan, prevents abdominal aortic aneurysm progression independently of blood pressure reduction by inhibiting proteolysis, apoptosis and inflammation in aortic tissue"
• Angiotensin II type 2 receptor blockade increases bone mass - J Biol Chem. 2008 Nov 11 - "Treatment with AT2 receptor blocker significantly enhanced the levels of bone mass and this effect was based on the enhancement of osteoblastic activity as well as the suppression of osteoclastic activity in vivo"
• Effects of Telmisartan and Ramipril on Adiponectin and Blood Pressure in Patients with Type 2 Diabetes - Am J Hypertens. 2008 Oct 30 - "There was a significant increase in adiponectin levels in the telmisartan (0.68 (95% confidence interval (CI), 0.27 to 1.10) microg/ml, P < 0.01) but not in the ramipril group" - See my adiponectin page.  An increase in adiponectin is a good thing.
• Telmisartan versus angiotension-converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials - J Hum Hypertens. 2008 Nov 6 - "Telmisartan had fewer drug-related adverse events than enalapril (RR 0.57, 95% CI 0.44-0.74), ramipril (RR 0.44, 95% CI 0.26-0.75), lisinopril (RR 0.70, 95% CI 0.56-0.89) and perindopril (RR 0.52, 95% CI 0.28-0.98). The meta-analysis indicates that telmisartan provides a superior BP control to ACEIs (enalapril, ramipril and perindopril) and has fewer drug-related adverse events and better tolerability in hypertensive patients" - Click here for reasons telmisartan might be a first line treatment.
• Beneficial Effects of Combination Therapy with Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor on Vascular Endothelial Function - Hypertens Res. 2008 Aug;31(8):1603-10 - "these results suggest that the angiotensin I-converting enzyme inhibitor perindopril is superior to the calcium channel blocker amlodipine for reducing vascular endothelial dysfunction when co-administered with angiotensin receptor blockers in patients with essential hypertension"
• Angiotensin receptor blockers in the treatment of NASH/NAFLD: Could they be a first-class option? - Adv Ther. 2008 Oct 29 - "Nonalcoholic fatty liver disease (NAFLD) ... nonalcoholic steatohepatitis (NASH) ... In our opinion there are two major advantages of ARBs that make them a possible therapeutic option for treating NASH and MS: their specific antihypertensive effect, and their impact on liver fibrosis. In light of this, and based on the current evidence (including existent human studies), we can speculate that some ARBs like telmisartan, candesartan, and losartan can be beneficial in treating NASH/NAFLD and its consequences, and further larger controlled clinical trials will bring consistent data into this field"
• Association of ACE Inhibitors and Angiotensin Receptor Blockers With Keratinocyte Cancer Prevention in the Randomized VATTC Trial - oncologystat.com, 9/3/08 - "squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs) ... Time to new BCC was 2.5 years for ACE inhibitor or ARB users and 2.2 years for nonusers. The absolute incidence rate of BCCs per 1000 patient-years was lower among ACE inhibitor/ARB users than nonusers (154 vs 233; unadjusted incidence rate ratio [IRR] = 0.66 ... Time to new SCC was 2.9 years for ACE inhibitor or ARB users and 2.6 years for nonusers. The absolute incidence rate of BCCs per 1000 patient-years was lower among ACE inhibitor/ARB users than nonusers (83 vs 141; unadjusted IRR = 0.58"
• Effects of telmisartan on adiponectin levels and body weight in hypertensive patients with glucose intolerance - Metabolism. 2008 Oct;57(10):1473-8 - "Telmisartan decreased body weight while increasing serum adiponectin levels in hypertensive patients with glucose intolerance. Candesartan did not achieve similar improvements in these patients. Among ARBs, telmisartan may have a larger impact on obesity-related diseases that can lead to cardiovascular disorders"
• Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial - Lancet. 2008 Aug 29 - "Telmisartan was well tolerated in patients unable to tolerate ACE inhibitors. Although the drug had no significant effect on the primary outcome of this study, which included hospitalisations for heart failure, it modestly reduced the risk of the composite outcome of cardiovascular death, myocardial infarction, or stroke"
• Medication To Lower Blood Pressure Reduces Outcome Of Cardiovascular Death, Heart Attack Or Stroke, Study Suggests - Science Daily, 8/31/08 - "Telmisartan reduced the outcome of cardiovascular death, heart attack, stroke or hospitalization for heart failure by a relative eight per cent ... However, when the outcome included cardiovascular death, heart attack or stroke (and not hospitalization for heart failure), telmisartan reduced that outcome by a significant 13 per cent"
• Angiotensin Inhibitors And Receptor Blockers Linked To Lower Risk Of Nonmelanoma Skin Cancer - Science Daily, 8/28/08 - "The group taking either an ACE inhibitor or ARBs had a 39 percent relative reduction in incidence of basal cell cancer and a 33 percent relative reduction in squamous cell cancers compared with nonusers"
• Comparison of the effects of telmisartan and olmesartan on home blood pressure, glucose, and lipid profiles in patients with hypertension, chronic heart failure, and metabolic syndrome - Hypertens Res. 2008 May;31(5):921-9 - "telmisartan had more beneficial effects on glucose and lipid profiles in patients with relatively high HbA1c, serum total and low-density lipoprotein cholesterol, and triglyceride levels. Therefore, we concluded that telmisartan was more beneficial than olmesartan for controlling blood pressure in the early morning, as well as for improving glucose and lipid profiles in patients with hypertension, chronic heart failure, and metabolic syndrome" - Click here for why I feel that telmisartan should be the first line treatment for hypertension.
• Telmisartan prevented cognitive decline partly due to PPAR-gamma activation - Biochem Biophys Res Commun. 2008 Aug 17 - "Pretreatment with a non-hypotensive dose of telmisartan significantly inhibited such cognitive decline. Interestingly, co-treatment with GW9662, a PPAR-gamma antagonist, partially inhibited this improvement of cognitive decline. Another ARB, losartan, which has less PPAR-gamma agonistic effect, also inhibited Abeta-injection-induced cognitive decline; however the effect was smaller than that of telmisartan and was not affected by GW9662. Immunohistochemical staining for Abeta showed the reduced Abeta deposition in telmisartan-treated mice. However, this reduction was not observed in mice co-administered GW9662. These findings suggest that ARB has a preventive effect on cognitive impairment in Alzheimer disease, and telmisartan, with PPAR-gamma activation, could exert a stronger effect"
• The angiotensin II receptor blocker telmisartan improves insulin resistance and has beneficial effects in hypertensive patients with type 2 diabetes and poor glycemic control - Diabetes Res Clin Pract. 2008 Aug 8 - "The telmisartan significantly improved HOMA-IR in hypertensive patients and also significantly decreased HbA1c in type 2 diabetic patients especially in the patients with poor glycemic control (HbA1c>==8.0%). These results indicate that telmisartan improves insulin resistance and gives beneficial effects in hypertensive patients with type 2 diabetes and a poor glycemic control"
• The angiotensin II receptor blocker telmisartan improves insulin resistance and has beneficial effects in hypertensive patients with type 2 diabetes and poor glycemic control - Diabetes Res Clin Pract. 2008 Aug 8 - "The telmisartan significantly improved HOMA-IR in hypertensive patients and also significantly decreased HbA1c in type 2 diabetic patients especially in the patients with poor glycemic control (HbA1c>==8.0%). These results indicate that telmisartan improves insulin resistance and gives beneficial effects in hypertensive patients with type 2 diabetes and a poor glycemic control" - Just another reason I feel that telmisartan should be the first line treatment for hypertension.  Click here for other reasons.  See telmisartan at OffshoreRx1.com.
• Angiotensin Receptor Blockers Are Lower Incidence, Progression Of Alzheimer's Disease - Science Daily, 7/27/08 - "Researchers at Boston University School of Medicine (BUSM) have, for the first time, found that angiotensin receptor blockers (ARBs)—a particular class of anti-hypertensive medicines—are associated with a striking decrease in the occurrence and progression of dementia"
• Telmisartan but not candesartan affects adiponectin expression in vivo and in vitro - Hypertens Res. 2008 Apr;31(4):601-6 - "the changes in serum adiponectin and plasma glucose over 3 months were significantly greater in the telmisartan group than in the candesartan group. In vitro, although the protein level of adiponectin was not significantly elevated, the mRNA expression of adiponectin was elevated 1.5-fold by telmisartan in 3T3-L1 adipocytes. Our findings suggest that telmisartan may have beneficial effects in type 2 diabetes beyond its antihypertensive effect" - I've been saying that telmisartan should be the first line treatment for hypertension for some time now if natural methods such as coenzyme Q10 don't work.
• Telmisartan, an Angiotensin II Type 1 Receptor Blocker, Improves Coronary Microcirculation and Insulin Resistance among Essential Hypertensive Patients without Left Ventricular Hypertrophy - Hypertens Res. 2008 Apr;31(4):615-22 - "Coronary flow velocity reserve (CFVR) ... CFVR was improved in the telmisartan group (2.4+/-0.4 to 2.9+/-0.4; p<0.01), but there was no difference in the nifedipine group (2.5+/-0.3 to 2.5+/-0.3; n.s.). HOMA-IR was improved in the telmisartan group (3.1+/-1.1 to 1.6+/-0.7; p<0.01), but there was no difference in the nifedipine group (2.8+/-1.1 to 2.4+/-0.7; n.s.). In conclusion, this study demonstrates that antihypertensive therapy with telmisartan, but not nifedipine, has a beneficial effect on coronary microcirculation and insulin resistance among essential hypertensive patients"
• Microalbuminuria Reduction with Telmisartan in Normotensive and Hypertensive Japanese Patients with Type 2 Diabetes: A Post-Hoc Analysis of the Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) Study - Hypertens Res. 2008 Apr;31(4):657-64 - "The patients treated with either dose of telmisartan showed lower transition rates from microalbuminuria to overt nephropathy compared to the placebo group. In addition, more patients on telmisartan reverted to normoalbuminuria (UACR<30 mg/g creatinine): 15.5% of the 40 mg group, 19.6% of the 80 mg group, and 1.9% of the placebo group ... Side effects did not differ among the groups. The present study demonstrates that telmisartan prevents the progression of microalbuminuria (in some cases induces remission of albuminuria) in normotensive Japanese patients with type 2 diabetes. Telmisartan is shown to be safe and well tolerated in these patients"
• Effect of irbesartan on erectile function in patients with hypertension and metabolic syndrome - Int J Impot Res. 2008 Jul 3 - "Erectile function increased significantly (P<0.0001) after 6 months of treatment with irbesartan, irrespective of dosage and independent of additional treatment with hydrochlorothiazide. Prevalence of ED declined to 63.7% from 78.5% at baseline, along with a significant increase in orgasmic function (P<0.001) and intercourse satisfaction (P<0.001). Treatment with irbesartan alone, as well as in combination with hydrochlorothiazide is associated with an improvement of sexual desire, frequency of sexual contacts and erectile function in hypertensive patients with the metabolic syndrome. These results suggest a beneficial role of angiotensin receptor antagonists in the treatment of metabolic syndrome, and ED" - Note:  I've been suggesting telmisartan (an ARB) for some time as the first line treatment for hypertension.  See telmisartan at OffshoreRX.
• Hypertension Treatment Effective In Reversing Vascular Damage, Study Suggests - Science Daily, 6/17/08 - "A hypertension medication called olmesartan medoxomil is effective in reversing the narrowing of the arteries that occurs in patients with high blood pressure ... After one year of treatment, olmesartan medoxomil improved the artery abnormalities in high blood pressure patients and returned arterial architecture to normal levels. This was not seen with the atenolol"
• Telmisartan is more effective than losartan in reducing proteinuria in patients with diabetic nephropathy - Kidney Int. 2008 May 21 - "telmisartan is superior to losartan in reducing proteinuria in hypertensive patients with diabetic nephropathy, despite a similar reduction in blood pressure" - Just one more reason I feel telmisartan should be the first line treatment for hypertension if natural methods such as coenzyme Q10 don't work.  See telmisartan at OffshoreRx1.com.
• Effects of Angiotensin Converting Enzyme Inhibitor and Angiotensin II Receptor Antagonist Combination on Nitric Oxide Bioavailability and Atherosclerotic Change in Watanabe Heritable Hyperlipidemic Rabbits - Hypertens Res. 2008 Mar;31(3):575-84 - "1) vehicle (control), 2) the ACEI enalapril (E: 3 mg/kg/day), 3) the ARB losartan (L: 30 mg/kg/day) and 4) enalapril (1.5 mg/kg/day) + losartan (15 mg/kg/day) (E+L). Intra-aortic infusion of ACh produced an increase in plasma NO concentration, which was significantly greater with all the drug treatments than with the control. E increased ACh-induced NO significantly more than L (by 6.9 nmol/L, and 4.7 nmol/L, respectively). E+L increased ACh-induced NO by 9.5 nmol/L, significantly more than either E or L ... the combined treatment with an ACEI and an ARB may have additive protective effects on endothelial function as well as atherosclerotic change"
• Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, or Both for Patients With Proteinuria? A Best Evidence Review - Medscape, 5/20/08 - "Most significantly, the addition of ACEIs to ARBs reduced proteinuria to a greater degree than ARBs alone (ratio of means 0.76 at 1 to 4 months and 0.75 at 5 to 12 months). Combination therapy was also superior to treatment with ACEIs alone ... The 2 important conclusions that can be drawn from this meta-analysis are that ARBs are not superior to ACEIs in improving proteinuria, and that the combination of these 2 treatments appears superior in this outcome compared with either treatment alone ... Two of the biggest safety concerns regarding the combination therapy include the risks for hyperkalemia and acute worsening of renal function. A review of the literature, however, suggests that these risks may not be significantly worse with combination treatment vs monotherapy"
• Telmisartan increases fatty acid oxidation in skeletal muscle through a peroxisome proliferator-activated receptor-gamma dependent pathway - J Hypertens. 2008 Jun;26(6):1209-1215 - "telmisartan may increase energy expenditure and protect against dietary induced obesity and features of the metabolic syndrome at least in part by increasing muscle fatty acid oxidation through activation of peroxisome proliferator-activated receptor-gamma"
• Meta-analysis of Randomized Controlled Trials Comparing Telmisartan With Losartan in the Treatment of Patients With Hypertension - Am J Hypertens. 2008 May;21(5):546-52. Epub 2008 Mar 20 - "In comparison with losartan, telmisartan provides superior control of BP and has no association with increased risk of adverse events"
• Valsartan Improves Arterial Stiffness in Type 2 Diabetes Independently of Blood Pressure Lowering - Hypertension. 2008 Apr 21 - "Increased arterial stiffness, as estimated from aortic pulse wave velocity (Ao-PWV), and albuminuria are independent predictors for cardiovascular disease in type 2 diabetes mellitus (T2DM) ... Ao-PWV showed a significantly greater reduction, mean (95% CI), -0.9 m/s (-1.4 to -0.3) for valsartan/HCTZ compared to amlodipine (P=0.002). AER fell significantly only with Val/HCTZ from 30.8(20.4, 46.5) to 18.2(12.5, 26.3) mcg/min, (P=0.01) with between treatment difference in favor of Val/HCTZ of -15.3mcg/min" - Telmisartan, another ARB and my first line plug, will decrease arterial stiffness also.  See:
  • Angiotensin II Antagonist Telmisartan Fights Stiffening Arteries In Hypertensive Diabetics - Doctor's Guide, 4/6/01 - "not only effectively lowered blood pressure compared with placebo, but also significantly decreased arterial stiffness" - See telmisartan at OffshoreRX.
• Blood Pressure Drugs Halt Pancreatic Cancer Cell Growth, Researchers Find - Science Daily, 4/14/08 - "one type of pressure-lowering drug called an angiotensin receptor blocker inhibits pancreatic cancer cell growth and causes cell death"
• Effects of telmisartan, a unique angiotensin receptor blocker with selective peroxisome proliferator-activated receptor-gamma-modulating activity, on nitric oxide bioavailability and atherosclerotic change - J Hypertens. 2008 May;26(5):964-972 - "In addition to a class effect of ARBs, telmisartan may have additional effects on nitric oxide bioavailability and atherosclerotic change through its PPARgamma-mediated effects in genetically hyperlipidemic rabbits" - Just one more reason to consider telmisartan as a first line treatment for hypertension. See telmisartan at OffshoreRx1.com.
• Telmisartan, an Angiotensin II Type 1 Receptor Blocker, Inhibits Advanced Glycation End-product (AGE)-elicited Hepatic Insulin Resistance via Peroxisome Proliferator-activated Receptor-gamma Activation - J Int Med Res. 2008 Mar-Apr;36(2):237-43 - "Candesartan, another ARB, did not affect AGEs-induced serine phosphorylation of IRS-1 at serine-307 residues in Hep3B cells. Our study suggests that telmisartan could improve AGE-elicited insulin resistance in Hep3B cells by inhibiting serine phosphorylation of IRS-1, at least in part, via activation of PPAR-gamma" - Note:  That might be another reason for considering telmisartan as a first line treatment for hypertension.  See telmisartan at OffshoreRx1.com.
• Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events - N Engl J Med. 2008 Mar 31 - "Telmisartan was equivalent to ramipril in patients with vascular disease or high-risk diabetes and was associated with less angioedema. The combination of the two drugs was associated with more adverse events without an increase in benefit" - Yeah but if you have to go with two drugs it sure seems like it's the least of all the evils regarding side effects.  See telmisartan at OffshoreRx1.com.
• ONTARGET: ARB Similar to ACE - Medscape, 3/31/08 - "The angiotensin receptor blocker (ARB) telmisartan (Micardis, Boehringer Ingelheim) was "noninferior" to the ACE inhibitor ramipril in patients with vascular disease or high-risk diabetes in the landmark ONTARGET trial"
• New Blood Pressure Medication Has Fewer Side Effects, Global Study Suggests - Science Daily, 3/31/08 - "The study found a new drug telmisartan is as effective as the popular drug ramipril in reducing cardiovascular death in high risk patients and it has fewer side effects" - I've been plugging telmisartan for some time now.  Click here.  See telmisartan at OffshoreRx1.com.
• Telmisartan treatment decreases visceral fat accumulation and improves serum levels of adiponectin and vascular inflammation markers in Japanese hypertensive patients - Hypertens Res. 2007 Dec;30(12):1205-10 - "telmisartan treatment was associated with an improvement of vascular inflammation, reductions in visceral fat and increases in serum adiponectin"
• Angiotensin II receptor blocker inhibits tumour necrosis factor-alpha-induced cell damage in human renal proximal tubular epithelial cells - Nephrology (Carlton). 2008 Mar 5 - "The present study demonstrates that TNF-alpha induces renal tubular cell damage in RPTEC and AT1/AT2 receptor blockers showed cytoprotective effects probably via at least partly different mechanism"
• Treatment of hypertension in individuals with the cardiometabolic syndrome: role of an angiotensin II receptor blocker, telmisartan - Expert Rev Cardiovasc Ther. 2008 Mar;6(3):289-303 - "Concerning drug treatment of hypertension associated with other cardiometabolic risk factors, many results of head-to-head studies have demonstrated a reduction in new-onset Type 2 diabetes in hypertensive patients treated with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, when compared with conventional antihypertensive therapy. The explanations of the different actions of both these drugs include several mechanisms related to pancreatic insulin release and insulin sensitivity improvement. Another mechanism by which the inhibition of the renin-angiotensin system may improve insulin sensitivity is through the partial peroxisome proliferator-activated receptor-gamma agonism of telmisartan. For that reason, telmisartan has been considered by some experts to be an antihypertensive agent that is particularly useful in the treatment of hypertension associated with cardiometabolic risk factors"
• Reduced incidence of new-onset atrial fibrillation with angiotensin II receptor blockade: the VALUE trial - J Hypertens. 2008 Mar;26(3):403-411 - "These findings suggest that angiotensin II receptor blockers may result in greater benefits than calcium antagonists in hypertensive patients at risk of new-onset AF"
• Effects of angiotensin II type 1-receptor blockade on retinal endothelial function - J Hypertens. 2008 Mar;26(3):516-22 - "AT1-receptor blockade with irbesartan improves endothelial function of the retinal vasculature, taken as a model of cerebral circulation"
• Effect of Telmisartan on Nitric Oxide-Asymmetrical Dimethylarginine System. Role of Angiotensin II Type 1 Receptor and Peroxisome Proliferator Activated Receptor {gamma} Signaling During Endothelial Aging - Hypertension. 2008 Feb 4 - "Telmisartan, in addition to blocking angiotensin (Ang) II type 1 receptor (AT1R), activates peroxisome proliferator activated receptor gamma (PPARgamma) signaling that interferes with nitric oxide (NO) system. Because aging of endothelial cells (ECs) is hallmarked by a reduction in NO synthesis, we hypothesized that telmisartan increases NO formation by regulated asymmetrical dimethylarginine (ADMA)-dimethylarginine dimethylaminohydrolase (DDAH)-system through blocking AT1R and activating PPARgamma signaling ... During the process of aging, PPARgamma protein expression decreased significantly, whereas the expression of AT1R increased. Telmisartan reversed these effects and dose-dependently decreased reactive oxygen species and 8-iso-prostaglandin (PG) F2alpha formation ... telmisartan mainly by activating PPARgamma signaling can alter the catabolism and release of ADMA as an important cardiovascular risk factor. We therefore propose that telmisartan translationally and posttranslationally upregulated DDAH expression via activation of PPARgamma signaling, causing ADMA to diminish and increase NO synthesis sufficient to delay senescence"
• Establishing A New Option for Target-organ Protection: Rationale for ARB Plus ACE Inhibitor Combination Therapy - Am J Hypertens. 2008 Jan 24 - "Combination therapy targeting RAS activation may reduce target-organ damage and provide superior blood pressure (BP) control; combining angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) represents one possible approach"
• ACE Inhibitors or ARBs in Hypertension? In Chronic Kidney Disease? - Medscape, 1/17/07 - "ARBs and ACE inhibitors were similarly effective at lowering proteinuria, ARBs were more effective than calcium-channel blockers, and a combination of ARBs and ACE inhibitors was more effective than either agent alone"
• The effect of losartan on hemoglobin concentration and renal outcome in diabetic nephropathy of type 2 diabetes - Kidney Int. 2007 Dec 19 - "Compared with placebo, losartan treatment was associated with a significant decrease of hemoglobin, with the largest between-group difference at 1 year. After adjustment, there were significant relative risk reductions for losartan compared with placebo for ESRD and for ESRD or death regardless of the baseline hemoglobin even in those patients with a baseline hemoglobin below 120 g l(-1). Hence, the renoprotective properties of losartan were maintained despite a significant lowering of the hemoglobin concentration"
• Sustained Tubulo-interstitial Protection in SHRs by Transient Losartan Treatment: An Effect of Decelerated Aging? - Am J Hypertens. 2008 Jan 10 - "Transient losartan treatment reduces cell-turnover not only acutely but also for a prolonged period after drug withdrawal. This results in the long-term in reduced aging and attenuated tubulo-interstitial damage, suggesting there exists a modulating effect of angiotensin II (ANGII)-antagonism on long-term cell turnover" - Note:  Losartan is an ARB.  I would think that telmisartan (also and ARB and my recommendation for hypertension) would give the same effect.
• ACE Inhibitors vs ARBs in HTN and in CKD - Medscape, 1/4/08 - "In the setting of chronic kidney disease (CKD), concludes the other study, which is a meta-analysis, ACE inhibitor and ARB monotherapy are similarly effective at reducing proteinuria, but a combination of the two angiotensin-2-suppressing drugs works better than either agent individually [2]. But a blanket recommendation to combine them would be premature, according to the authors, because there is little evidence that the combination would improve clinical outcomes over monotherapy, and the safety of such combination therapy is largely undefined"
• Anti-atherosclerotic properties of telmisartan in advanced atherosclerotic lesions in apolipoprotein E deficient mice - Atherosclerosis. 2007 Dec 17 - "These data suggest that chronic inhibition of the RAS by telmisartan prevails in reducing advanced atherosclerosis and promoting plaque stability over ramipril, possibly through the reduced activity of the pro-inflammatory transcription factors NFkappaB and Egr-1 and through the activation of PPARgamma"
• Blood Pressure Drug Telmisartan Shows Powerful Activity Against Stroke, Study Suggests - Science Daily, 12/17/07 - "83 percent of rats given no medication showed signs of stroke, as did 56 percent of rats given ramipril alone. However, no strokes were noted in the telmisartan-only or the telmisartan/ramipril combo groups ... Telmisartan's ability to easily pass through the blood-brain barrier (something ramipril cannot do) is likely behind the neuroprotective effect noted in the study"
• Effect of the Angiotensin Receptor Blocker Irbesartan on Metabolic Parameters in Clinical Practice: the DO-IT Prospective Observational Study - Cardiovasc Diabetol. 2007 Nov 27;6(1):36 - "Six months of irbesartan therapy decreased systolic blood pressure by 14% (157.4+/-14.7 vs. 135.0+/-10.7 mmHg) and diastolic blood pressure by 13% (92.9+/-9.2 vs. 80.8+/-6.8 mmHg). This was associated with a decrease in body weight (-2.3%), fasting glucose (-9.5%), HbA1c (-4.6%), LDL-cholesterol (-11%), triglycerides (-16%) and gamma-GT (-12%) and an increase in HDL-cholesterol (+5%)"
• Renoprotective effect of the addition of losartan to ongoing treatment with an Angiotensin converting enzyme inhibitor in type-2 diabetic patients with nephropathy - Hypertens Res. 2007 Oct;30(10):929-35 - "During the 12-month treatment, addition of losartan or addition of an ACE-I to the treatment protocol reduced systolic blood pressure (SBP) by 10% and 12%, diastolic blood pressure (DBP) by 7% and 4%, and urinary albumin excretion by 38% and 20% of the baseline value, respectively. However, the effects on both BP and urinary albumin were not significantly different between the two therapies. In conclusion, addition of losartan or an ACE-I to an ongoing treatment with an ACE-I, or addition of an ACE-I to ongoing treatment with a conventional antihypertensive were equally effective at reducing the urinary albumin excretion and BP, and provided renal protection in patients with type-2 diabetic nephropathy"
• Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension - Ann Intern Med. 2007 Nov 5 - "Available evidence shows that ACE inhibitors and ARBs have similar effects on blood pressure control, and that ACE inhibitors have higher rates of cough than ARBs. Data regarding other outcomes are limited"
• High-Dose Candesartan Reduces Persistent Proteinuria - Doctor's Guide, 11/6/07
• Candesartan Improves Outcomes in Diabetes, Kidney Patients - Doctor's Guide, 11/8/07 - "new onset diabetes occurred in just 1.1% of the 1,024 patents on candesartan compared with 2.9% of the patients treated with other blood pressure lowering medications that did not include angiotensin receptor blockers ... "We observed that treatment with candesartan reduced that risk by 63% (P =.027)," he said during a press briefing. He also noted that patients on candesartan had fewer adverse events than the 1,025 patients who received standard therapy" - I would have liked to see telmisartan (also an ARB) in this study.
• Common Medications Provide Equal Blood Pressure Control - Doctor's Guide, 11/2/07 - "Two common classes of blood pressure medications – angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) – are equally effective at controlling high blood pressure ... ACEIs are slightly more likely than ARBs to cause a harmless but persistent dry cough ... If left untreated, high blood pressure can cause catastrophic health problems: the heart may enlarge, which can lead to heart failure; small bulges --aneurysms -- may form in blood vessels, including the aorta (the main artery to the heart) and others in the brain, legs, and intestines; blood vessels in the kidney may narrow, causing kidney failure; blood vessels in the eyes may burst or bleed, possibly leading to blindness; and arteries throughout the body may "harden" faster, potentially leading to heart attack or stroke"
• Renoprotection provided by losartan in combination with pioglitazone is superior to renoprotection provided by losartan alone in patients with type 2 diabetic nephropathy - Kidney Blood Press Res. 2007;30(4):203-11 - "Renoprotection conferred by losartan combined with pioglitazone is superior to that conferred by losartan alone in subjects with type 2 diabetic nephropathy. The combination is generally well tolerated"
• Drugs For Hypertension May Help Prevent And Treat Alzheimer's Disease - Science Daily, 10/26/07 - "mice genetically determined to develop Alzheimer's disease beta-amyloid production and subsequent cognitive deterioration, significantly benefit from the treatment with the anti-hypertensive agent Valsartan, found to pharmacologically prevent beta-amyloid production in the brain even when delivered to Alzheimer's disease mice at doses 3-4 fold lower than the minimal equivalent dose prescribed for the treatment of hypertension in humans. Other anti-hypertension drugs with beneficial results included Propranolol HCI, Carvedilol, Losartan, Nicardipine HCI, Amiloride HCI and Hydralazine HCI" - Note:  I'm big on Micardis (telmisartan).  Valsartan and losartan (generic names so they shouldn't have been capitalized) are also ARBs.  I'm wondering if telmisartan was in the study.
• Do ACE inhibitors and ARBs mix well? Analysis urges caution - theheart.org, 10/10/07 - "patients receiving both an ACE inhibitor and an ARB were more likely not to comply with therapy due to side effects, which included hypotension, cough, angioedema, worsening renal function as defined by a change in serum creatinine >0.5 mg/dL, hyperkalemia as defined by serum potassium level changes >5.5 mEq/L, and symptomatic hypotension"
• Adverse Effects of Combination Angiotensin II Receptor Blockers Plus Angiotensin-Converting Enzyme Inhibitors for Left Ventricular Dysfunction: A Quantitative Review of Data From Randomized Clinical Trials - Arch Intern Med. 2007 Oct 8;167(18):1930-6 - "there were significant increases in worsening renal function (RR, 2.17 [95% CI, 1.59-2.97] and RR, 1.61 [95% CI, 1.31-1.98], respectively), hyperkalemia (RR, 4.87 [95% CI, 2.39-9.94] and RR, 1.33 [95% CI, 0.90-1.98], respectively"
• Prevention of stroke in patients with hypertension - Am J Cardiol. 2007 Aug 6;100(3A):17J-24J - "In contrast to angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers (ARBs) provide consistent benefits in stroke protection beyond blood pressure lowering. The ARB telmisartan has a particularly interesting profile for stroke management. Selective angiotensin II type 1 receptor blockade and 24-hour blood pressure control with telmisartan provide the potential for improved stroke prevention"
• Rationale for double renin-angiotensin-aldosterone system blockade - Am J Cardiol. 2007 Aug 6;100(3A):25J-31J - "The clinical benefits of both angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) extend beyond blood pressure reduction to encompass tissue-protective effects in target organs, such as the heart, vasculature, and kidneys, that underlie the reductions in cardiovascular mortality and morbidity seen in large outcome trials. However, these effects are achieved by different mechanisms. ACE inhibitors reduce circulating and tissue angiotensin II levels and potentiate the beneficial effects of bradykinin, including generation of nitric oxide (NO). By contrast, the protective effects of ARBs are owing to the blockade of the angiotensin II type 1 (AT(1)) receptors and possibly also to the stimulation of angiotensin II type 2 (AT(2)) receptors, again resulting in NO release. In addition, some ARBs, such as telmisartan, are selective activators of peroxisome proliferator-activated receptor-gamma (PPAR-gamma), thereby increasing insulin sensitivity. In contrast to other PPAR-gamma ligands, such as the thiazolidinediones, activation of this receptor by telmisartan does not result in weight gain. The complementary mechanisms of action of ACE inhibitors and ARBs create a rationale for combination therapy in high-risk patients"
• Angiotensin receptor blockers versus angiotensin-converting enzyme inhibitors: where do we stand now? - Am J Cardiol. 2007 Aug 6;100(3A):38J-44J - "Both classes of agent can prevent or reverse endothelial dysfunction and atherosclerosis, thereby potentially reducing the risk of cardiovascular events. Such a reduction has been shown with ACE inhibitors in patients with coronary artery disease, but no such data are currently available for ARBs. Both ACE inhibitors and ARBs have been shown to reduce damage in target organs, such as the heart and kidney, and to decrease cardiovascular mortality and morbidity in patients with congestive heart failure"
• New opportunities in cardiovascular patient management: a survey of clinical data on the combination of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers - Am J Cardiol. 2007 Aug 6;100(3A):45J-52J - "Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) differ in their actions on the renin-angiotensin-aldosterone system (RAAS). ACE inhibitors prevent the formation of angiotensin II, although angiotensin II may still be generated by alternative pathways. However, ACE inhibitors interrupt bradykinin breakdown, which in turn potentially enhances nitric oxide and prostacyclin mechanisms. In contrast, ARBs selectively prevent the binding of angiotensin II to the angiotensin type 1 (AT(1)) receptor while leaving the potentially beneficial effects of the AT(2) receptor unaffected. The supposition is that dual blockade of the RAAS effectively overcomes the harmful effects of angiotensin II mediated by the AT(1) receptor while offering the additional effects of the ACE inhibitor"
• Telmisartan Improves Endothelial Function and Nitrate Tolerance in Patients With Coronary Artery Disease and the Metabolic Syndrome - Doctor's Guide, 9/11/07 - "Telmisartan is mainly an angiotensin II receptor blocker, but recently it has [shown] antioxidant effects and insulin resistance improvement effects ... After 4 weeks of treatment, the endothelium-dependant measure of flow-mediated dilatation was significantly increased in the telmisartan group (P <.01, vs control group), indicating improvements in endothelial dysfunction with telmisartan"
• ACE-I/ARB treatment in type 1 diabetes patients with albuminuria is associated with lower odds of progression of coronary artery calcification - J Diabetes Complications. 2007 Sep-Oct;21(5):273-9 - "coronary artery calcification (CAC) ... In backward logistic regression, presence of albuminuria at baseline predicted progression of CAC among subjects not treated with ACE-I/ARB [odds ratio=4.06 ... Among the subjects with albuminuria, the odds of progression was 62% lower (95% CI=88% decrease to 23% increase; P=.106) in those treated with ACE-I/ARB ... Albuminuria is a significant independent risk factor for CAC progression in young type 1 diabetes patients asymptomatic for CAD, and ACE-I/ARB treatment is associated with substantially lower odds of CAC progression"
• Heart Damage Can Be Reversed with Early Treatment - Science Daily, 8/27/07 - "During the first six months of the study, 38 subjects received a placebo, and the other 38 subjects took 160mg of Valsartan, a drug that blocks a hormone that is detrimental to the blood vessels and the heart. During the next six months, both groups took Valsartan ... Those who took the drug for the first six months significantly reduced their Rasmussen Disease Score compared with those who took the placebo. At the 12-month mark -- after both groups were taking the drug -- every patient showed better Rasmussen Disease Scores, effectively demonstrating that Valsartan can slow progression and even reverse early cardiovascular disease in asymptomatic high-risk patients"
• Telmisartan, an Angiotensin II Type 1 Receptor Blocker, Inhibits Advanced Glycation End-product (AGE)-induced Monocyte Chemoattractant Protein-1 Expression in Mesangial Cells Through Downregulation of Receptor for AGEs via Peroxisome Proliferator-activated Receptor-gamma Activation - J Int Med Res. 2007 Jul-Aug;35(4):482-9 - "Candesartan, an Ang II type 1 receptor blocker, did not suppress AGEs-induced superoxide generation. Telmisartan and the antioxidant, N-acetylcysteine, completely inhibited AGEs-induced MCP-1 overproduction by mesangial cells"
• Vitamin C 'benefits diabetics' - BBC News, 6/28/07 - "Vitamin C neutralises free radicals, while Telmisarten stimulates the natural removal of the molecules by cells"
• Telmisartan Staves Off Overt Diabetic Nephropathy - Medscape, 6/27/07 - "During a mean follow-up of 1.3 years, transition rates to overt nephropathy were significantly lower with telmisartan 40 mg (22.6%) and telmisartan 80 mg (16.7%) than with placebo (49.9%)"
• Angiotensin Receptor Blockers: Benefits Beyond Blood Pressure Lowering? - Medscape, 6/26/07 - "I would say that at this time, both ACE inhibitors and ARBs can be said to be useful in preventing or delaying progression of nondiabetic patients into type 2 diabetes"
• Baseline Glycaemic Control Has No Effect on Telmisartan-Related Improvements in Diabetics With Nephropathy - Doctor's Guide, 6/25/07 - "Chronic telmisartan treatment may slow the progression of renal disease in patients with type 2 diabetes and diabetic nephropathy, irrespective of baseline glycaemic control"
• Telmisartan May Help Preserve Renal Function in Patients With Hypertension, Diabetes - Medscape, 6/1/07 - "In patients with hypertension and type 2 diabetes, telmisartan and ramipril both may help preserve cardiovascular and renal function by increasing nitric oxide (NO) activity of the renal endothelium"
• The Differential Effects of Angiotensin II Type 1 Receptor Blockers on Microalbuminuria in Relation to Low-Grade Inflammation in Metabolic Hypertensive Patients - Am J Hypertens. 2007 May;20(5):565-72 - "There was a significant increase in high molecular weight adiponectin in the telmisartan group ... The reductions of microalbuminuria and high-sensitivity C-reactive protein (hs-CRP) were significant in the telmisartan group"
• Telmisartan-Hydrochlorothiazide Outperforms Valsartan-Hydrochlorothiazide for Blood Pressure Reduction - Doctor's Guide, 5/29/07 - "The change in diastolic blood pressure was -18.2 mmHg for the telmisartan-hydrochlorothiazide group and -17.0 mmHg for the valsartan-hydrochlorothiazide group. The change in systolic blood pressure was -24.6 mmHg and -22.5 for the two groups, respectively"
• Telmisartan Reduces Proteinuria More Than Losartan - Doctor's Guide, 5/28/07 - "Our findings suggest that at similar levels of blood pressure control, telmisartan may confer greater protection against progression to end-stage renal disease"
• Metabolic effects of telmisartan and irbesartan in type 2 diabetic patients with metabolic syndrome treated with rosiglitazone - J Clin Pharm Ther. 2007 Jun;32(3):261-8 - "Telmisartan seemed to improve glycaemic and lipid control and metabolic parameters of the metabolic syndrome better than irbesartan"
• Combination therapy with an ACE inhibitor and an angiotensin receptor blocker for diabetic nephropathy: a meta-analysis - Diabet Med. 2007 May;24(5):486-93 - "This meta-analysis suggests that ACEI + ARB reduces 24-h proteinuria to a greater extent than ACEI alone. This benefit is associated with small effects on GFR, serum creatinine, potassium and blood pressure"
• The effect of telmisartan and ramipril on early morning blood pressure surge: a pooled analysis of two randomized clinical trials - Blood Press Monit. 2007 Jun;12(3):141-147 - "Telmisartan significantly reduced the early morning systolic blood pressure surge compared with ramipril"
• Angiotensin II receptor blockers downsize adipocytes in spontaneously type 2 diabetic rats with visceral fat obesity - Am J Hypertens. 2007 Apr;20(4):431-6 - "adipocyte downsizing was significantly greater with telmisartan compared to valsartan. The likely mechanism for this difference was thought to be the PPAR-gamma-mediated action of telmisartan"
• Combination ACE inhibitor and angiotensin receptor blocker therapy - future considerations - J Clin Hypertens (Greenwich). 2007 Jan;9(1):78-86. - "The individual gains seen with each of these drug classes have led to speculation that their combination might offer additive if not synergistic outcome benefits. The foundation of this hypothesis, although biologically possible, has thus far not been sufficiently well proven to support the everyday use of these 2 drug classes in combination. Additional outcomes trials, which are currently proceeding to their conclusion, may provide the necessary proof to support an expanded use of these 2 drug classes in combination"
• Treating the metabolic syndrome - Expert Rev Cardiovasc Ther. 2007 May;5(3):491-506 - "appropriate treatment of MS components often requires pharmacologic intervention with insulin-sensitizing agents, such as metformin and thiazolidinediones, while statins and fibrates, or angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are the first-line lipid-modifying or antihypertensive drugs"
• Novel ARB Provides Greater Reductions in Proteinuria in Diabetics With Overt Nephropathy - Medscape, 5/22/07 - "One year of treatment with the novel angiotensin receptor blocker (ARB) telmisartan provided greater reductions in proteinuria when compared with losartan, a drug approved for the treatment of diabetic nephropathy to prevent renal-disease progression"
• Valsartan Cuts C-Reactive Protein Levels in Prediabetics - Doctor's Guide, 5/22/07 - "In diabetic patients with abdominal obesity, after 16 weeks of hydrochlorothiazide therapy, median hsCRP values were increased 16% (4.9 vs 3.7 mg/L at baseline, P <.05) but decreased 9% in patients on valsartan (3.7 vs 4.1 mg/L at baseline, P <.05) and 5% in patients on combination therapy"
• Valsartan Is a Prudent Choice in Young Hypertensives - Doctor's Guide, 5/21/07
• ARBs for the Treatment of Heart Failure: A Class Effect? - Medscape, 5/15/07 - "Our results suggest that all ARBs are not equivalent. Valsartan, irbesartan, and candesartan were all associated with better survival rates when compared with losartan. The comparison for telmisartan was not statistically significant, possibly because this group included the smallest number of patients. In addition, there are no data from randomized trials on the effect of telmisartan on mortality in patients with heart failure"
• Angiotensin II receptor blockers for the treatment of heart failure: a class effect? - Pharmacotherapy. 2007 Apr;27(4):526-34 - "Elderly patients with heart failure who were prescribed losartan had worse survival rates compared with those prescribed other commonly used ARBs"
• Metabolic effects of telmisartan and irbesartan in type 2 diabetic patients with metabolic syndrome treated with rosiglitazone - J Clin Pharm Ther. 2007 Jun;32(3):261-8 - "Telmisartan seemed to improve glycaemic and lipid control and metabolic parameters of the metabolic syndrome better than irbesartan. These differences could be relevant in the choice of therapy for this condition and diabetes"
• Effect of antihypertensive agents on plasma adiponectin levels in hypertensive patients with metabolic syndrome - Nephrology (Carlton). 2007 Apr;12(2):147-53 - "Ramipril and valsartan increased the plasma adiponectin levels significantly higher than the other regimens"
• Effects of telmisartan on fat distribution in individuals with the metabolic syndrome - J Hypertens. 2007 Apr;25(4):841-8 - "The visceral fat area, determined by abdominal computed tomography scan, was reduced in the telmisartan group after 24 weeks' treatment"
• Telmisartan shows an equivalent effect of vitamin C in further improving endothelial dysfunction after glycemia normalization in type 1 diabetes - Diabetes Care. 2007 Apr 24 - "Combining insulin and vitamin C normalized endothelial dysfunction and decreased oxidative stress to normal level. Telmisartan significantly improved basal endothelial function and decreased nitrotyrosine plasma levels. In patients treated with Telmisartan a near normalization of both flow mediated vasodilation and oxidative stress was achieved when glycemia was normalized, while adding vitamin C infusion did not show further effect on endothelial function or nitrotyrosine plasma levels"
• The effects of telmisartan and amlodipine on metabolic parameters and blood pressure in type 2 diabetic, hypertensive patients - J Renin Angiotensin Aldosterone Syst. 2006 Dec;7(4):243-6 - "Group A: rosiglitazone (RSG) 4 mg + Telm 80 mg; Group B: RSG 4 mg + Aml 10 mg ... Lower values of glucose, HbA1C, HOMA index and higher adiponectin levels were observed in Group A compared to Group B ... insulin sensitivity may confer make Telm particularly suitable in the treatment of the metabolic syndrome"
• ACE Inhibitors Provide Greater Heart Protection - Science Daily, 4/22/07 - "Our research evaluated the effects of both drugs, and found that they both provided comparable blood pressure reduction. However, ACE inhibitors reduced the risk of coronary heart disease in patients by a further 9%. This so-called blood pressure-independent effect was not seen for ARBs"
• FDA Panel Favors First-Line Use of Irbesartan/HCTZ Combo - Medscape, 4/19/07 - "The US FDA Cardiovascular and Renal Drugs Advisory Committee recommended extended use of the combination product irbesartan plus hydrochlorothiazide (Avalide, Bristol-Myers Squibb) for the first-line treatment of hypertension" - Yeah, if you can get by the side effects of hydrochlorothiazide plus the increased chance of diabetes.  Irbesartan is a ARB and hydrochlorothiazide is a diuretic.  I'm not a doctor and here I am criticizing those who are but I still feel that telmisartan (a ARB)/ramipril (a ACE inhibitor) should be the first time treatment.  Click here for the research.   Some doctors claim you can't mix a ARB with an ACE inhibitor but I couldn't find any evidence of that.
• Treating hypertension in the patient with overt diabetic nephropathy - Semin Nephrol. 2007 Mar;27(2):182-94 - "The renoprotective and proteinuria-decreasing effects of angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers recommend these agents as the standard of care in type 2 diabetic nephropathy"
• The effects of irbesartan and telmisartan on metabolic parameters and blood pressure in obese, insulin resistant, hypertensive patients - J Endocrinol Invest. 2006 Dec;29(11):957-61 - "The greater impact on the improvement of the metabolic profile showed by telmisartan and the inverse correlation between adiponectin levels and blood pressure may be partly due to the action as partial PPARgamma agonist displayed by telmisartan"
• Effect of inhibition of the Renin-Angiotensin system on development of type 2 diabetes mellitus (meta-analysis of randomized trials) - Am J Cardiol. 2007 Apr 1;99(7):1006-12. Epub 2007 Feb 16 - "In ACE inhibitor trials, the odds of developing DM were reduced by 28% (OR 0.72, 95% CI 0.63 to 0.84, p <0.001), and in the 5 ARB studies, there was a 27% reduction (OR 0.73, 95% CI 0.64 to 0.84, p <0.001) in the odds. In conclusion, evidence accumulated to date indicates that inhibition of the renin-angiotensin system may contribute to the prevention of DM"
• Effect of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension - J Hypertens. 2007 Apr;25(4):785-791 - "losartan significantly improved endothelial function in type 2 diabetes patients with hypertension compared with atenolol. This must be independent of the blood pressure-lowering effect of losartan and is probably caused by an antioxidative effect of the angiotensin receptor blocker"
• Telmisartan and irbesartan therapy in type 2 diabetic patients treated with rosiglitazone: effects on insulin-resistance, leptin and tumor necrosis factor-alpha - Hypertens Res. 2006 Nov;29(11):849-56 - "The decrease in HbA1c and FPG at 12 months was statistically significant only in the telmisartan group"
• Angiotensin receptor blockade in diabetic renal disease-Focus on candesartan - Diabetes Res Clin Pract. 2007 Mar 3 - "In patients with type 2 diabetes and varying degrees of albuminuria, treatment with candesartan 8-32mg daily was shown to reduce urinary albumin excretion (UAE) by up to 60%. When given in addition to an ACE inhibitor (dual blockade), reductions in UAE of 25-35% relative to ACE inhibitor monotherapy have been found"
• Impact of Telmisartan Versus Ramipril on Renal Endothelial Function in Patients with Hypertension and Type 2 Diabetes - Diabetes Care. 2007 Mar 2 - "In patients with type 2 diabetes telmisartan and ramipril both increased NO activity of the renal endothelium significantly that in turn may support the preservation of cardiovascular and renal function"
• Angiotensin type-1 receptor blockade with losartan increases insulin sensitivity and improves glucose homeostasis in subjects with type 2 diabetes and nephropathy - Nephrol Dial Transplant. 2007 Feb 17 - "Fasting blood glucose, HbA1c, AUC glucose, and urinary protein values were significantly decreased in the losartan group as compared with the amlodipine group (P < 0.05). Furthermore, C-peptide concentrations, the insulin sensitivity index, and the insulin-to-glucose ratio were significantly increased after 3 months of therapy with losartan as compared to amlodipine"
• The effects of irbesartan and telmisartan on metabolic parameters and blood pressure in obese, insulin resistant, hypertensive patients - J Endocrinol Invest. 2006 Dec;29(11):957-61 - "Group A (23) was submitted to irbesartan 150 mg/day, Group B (23) to telmisartan 80 mg/day for 6 months ... Both irbesartan or telmisartan reduced blood pressure and ameliorated the insulin sensitivity, with increased adiponectin values; in Group B, the amelioration of metabolic parameters was greater than in Group A"
• Telmisartan improves lipid metabolism and adiponectin production but does not affect glycemic control in hypertensive patients with type 2 diabetes - Adv Ther. 2007 Jan-Feb;24(1):146-53 - "Triglyceride levels were significantly decreased, however, and adiponectin levels were significantly increased"
• Telmisartan reduced blood pressure and HOMA-IR with increasing plasma leptin level in hypertensive and type 2 diabetic patients - Diabetes Res Clin Pract. 2007 Jan 18 - "Fasting IRI and HOMA-IR were significantly decreased after Telmisartan treatment, suggesting the improved insulin sensitivity"
• The effect of telmisartan on glucose and lipid metabolism in nondiabetic, insulin-resistant subjects - Metabolism. 2006 Sep;55(9):1149-54 - "in insulin-resistant persons 12 weeks of telmisartan result in a significant improvement in glucose metabolism with a predominant improvement in beta-cell function"
• Blood Pressure Drugs Could Help Halt Pancreatic Cancer Spread, Researchers Find - Science Daily, 12/8/06 - "two types of pressure-lowering drugs -- ACE inhibitors and AT1R blockers -- may help reduce the development of tumor-feeding blood vessels, a process called angiogenesis. Such drugs, they say, may become part of a novel strategy to control the growth and spread of cancer ... In the test tube, Ang II significantly enhanced VEGF production in AT1R-positive cells. Captopril and losartan both blocked this effect"
• Study Shows Valsartan Reduced Urinary Protein Excretion in Patients with Type 2 Diabetes and High Blood Pressure - Doctor's Guide, 11/20/06 - "In patients with high blood pressure and type 2 diabetes, the blood pressure-lowering medication Diovan® (valsartan) significantly reduced urinary protein excretion, with high doses providing the greatest sustained reduction"
  • 24-hour urine protein - Medline Plus - "Increased urinary protein is usually measured when glomerular disease is suspected. The deterioration in the integrity of the glomerulus allows albumin to permeate in large quantities. Glomerular disease, such as nephrotic syndrome may result in urine protein (mostly urine albumin) of greater than 3.5 gm/day. So-called microalbuminuria with urine albumin levels of 30 to 200 mg/day is considered an early sign of diabetic nephropathy."
• Improved insulin sensitivity with the angiotensin II-receptor blocker losartan in patients with hypertension and other cardiovascular risk factors - J Hum Hypertens. 2006 Sep 21 - "angiotensin II-receptor blockade with losartan improves glucose metabolism at the cellular level beyond what can be expected by the vasodilatation and blood pressure reduction alone"
• Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Type 1 Receptor Blockers on the Rate of New-Onset Diabetes Mellitus: A Review and Pooled Analysis - Pharmacotherapy. 2006 Sep;26(9):1297-306 - "The combined occurrence of new-onset diabetes in all 13 studies was 2249 cases among 31,283 patients (7.2%) in the ACE inhibitor or ARB group versus 3230 cases among 35,988 patients (9.0%) in the control group"
• Cardiovascular Events Reduced in Japanese JIKEI Study With Valsartan - Doctor's Guide, 9/5/06 - "Blood pressure control was equal in both arms of the study, but the difference in outcomes was substantial and there were significant decreases in cardiovascular events with valsartan, specifically stroke, bouts of angina, heart failure and the need for hospitalization due to cardiac events"
• Short-term administration of an angiotensin-receptor antagonist in patients with impaired fasting glucose improves insulin sensitivity and increases free IGF-I - Eur J Endocrinol. 2006 Aug;155(2):293-6 - "received 100 mg losartan during 8 weeks ... After the treatment period, the HOMA score for insulin resistance had decreased from 5.3 +/- 1.1 to 3.7 +/- 0.9 (P = 0.004) and the 2-h CIGMA score from 23.4 +/- 3.1 to 15.9 +/- 2.1 (P = 0.07). The serum levels of free IGF-I had increased from 57 +/- 18.8 to 134 +/- 31.3 pmol/l" - Does that mean you can more than double you IGF-1 just by taking an ARB instead of hGH?  I don't know.  See losartan at OffshoreRx1.com. - Ben
• Renal and vascular protective effects of telmisartan in patients with essential hypertension - Hypertens Res. 2006 Aug;29(8):567-72 - "telmisartan is more effective at protecting renal function and vascular endothelial function, and at improving arteriosclerosis than the calcium channel blocker in patients with essential hypertension"
• ACE Inhibitors and Angiotensin Receptor Antagonists and the Incidence of New-Onset Diabetes Mellitus : An Emerging Theme - Drugs. 2006;66(9):1169-1177 - "These trials have demonstrated an approximately 15-30% reduction in the new onset of diabetes in those receiving ACE inhibitors and ARBs when compared with placebo or other active therapy"
• Angiotensin Receptor Blocker Added to Previous Antihypertensive Agents on Arteries of Diabetic Hypertensive Patients - Hypertension. 2006 Jun 19 - "After 1 year of treatment, resistance artery media:lumen ratio decreased in the valsartan group (7.9+/-0.5% after versus 9.8+/-0.6% before; P<0.05) but not in the atenolol-treated group"
• Incidence of Atrial Fibrillation Significantly Reduced by Candesartan Cilexetil Therapy in Heart Failure Patients - Doctor's Guide, 7/5/06
• Telmisartan Provides Superior, Powerful Blood Pressure Reduction From Morning to Morning Compared to Other Leading ARBS - Doctor's Guide, 6/15/06 - "telmisartan provides superior, powerful blood pressure reduction from morning to morning compared to other leading angiotensin II receptor blockers"
• Valsartan the First Blood Pressure Medication in a Large-Scale Clinical Trial to Lower C-Reactive Protein, an Important Marker of Inflammation - Doctor's Guide, 5/26/06 - "The median change in hsCRP from baseline after six weeks in the Diovan group was -0.12 mg/L compared to +0.05 mg/L in the Diovan HCT group, representing a difference between the treatment groups of 13.3%"
• Valsartan Lowers C-reactive Protein Levels; Combination Doesn't - Doctor's Guide, 5/19/06 - "Paradoxically, adding a diuretic to valsartan (Diovan) allows even more patients to reach blood pressure goals -- but appears to raise levels of C-reactive protein ... the monotherapy patients achieved an 8.9% reduction while the combination patients experienced a 4.4% increase"
• Reduced Diabetes Likelihood in Hypertensives Starting Valsartan Treatment - Doctor's Guide, 5/18/06 - "Over a mean follow-up of 4.2 years, the risk of diabetes was 11.5% for valsartan versus 14.5% for amlodipine; the odds ratio was 0.77 in favor of valsartan"
• New treatment strategies for patients with hypertension and insulin resistance - Am J Med. 2006 May;119(5 Suppl 1):S24-30 - "older antihypertensive agents such as thiazide diuretics and beta-blockers have potentially adverse effects on glucose and lipid metabolism and may even the exacerbate the metabolic syndrome and increase risk of type 2 diabetes ... Evidence is accumulating that telmisartan, in addition to blocking the angiotensin II type 1 receptor, activates the peroxisome proliferator-activated receptor (PPAR)-gamma a well-known target for treatment of the metabolic syndrome and diabetes ... the ability of telmisartan both to activate PPAR-gamma and to block the angiotensin receptor may provide added value not only in the treatment of the metabolic syndrome and prevention of type 2 diabetes but also in prevention and treatment of atherosclerotic cardiovascular disease"
• Telmisartan: The ACE of ARBs?  - Sharma 47 (5): 822 -- Hypertension, 3/27/06 - "telmisartan also reduced weight gain, increased total energy expenditure, and increased expression of key mitochondrial enzymes (cyclooxygenase-1 and mitochondrial transcription factor A) in skeletal muscle"
• New Drug Delays High Blood Pressure - WebMD, 3/14/06 - "the blood-pressure-lowering drug Atacand may be able to delay the development of full-blown hypertension among people whose blood pressure is slightly high ... taking the drug for two years appeared to prime the body to keep blood pressure in check, even when the person stopped the drug for another two years"
• ACE Inhibitors and ARBs vs. Other Antihypertensives - Medscape, 3/9/06 - "When diabetics and nondiabetics were analyzed together, ACE inhibitors or ARBs were significantly more effective than other antihypertensives in reducing ESRD incidence, serum creatinine levels, and albuminuria, but they had no significant effect on preventing doubling of serum creatinine or reduction in GFR. In diabetics, ACE inhibitors or ARBs were significantly more effective than other antihypertensives only in reducing albuminuria; in nondiabetics, ACE inhibitors or ARBs were more effective than other agents only in reducing albuminuria and serum creatinine levels"
• Blood pressure control in eldery hypertension - Nippon Rinsho. 2006 Jan;64(1):75-80 - "Because ACE inhibitors/ARBs or Ca blockers increase insulin sensitivity, these drugs should be used as the first choice in cases of elderly hypertensive patients complicated with diabetes mellitus"
• Valsartan Inhibits Platelets (VIP) Trial - Medscape, 2/3/06
• Addition of an angiotensin receptor blocker to full-dose ACE-inhibition: controversial or common sense? - Eur Heart J. 2005 Nov;26(22):2361-7 - "combination of a full-dose ACE-inhibitor and an ARB can be a rational choice in selected patients" - [full article]
• Olmesartan Improves Insulin Resistance in Chronic Kidney Disease Patients - Doctor's Guide, 11/15/05
• Titration-Extension Study Shows Losartan-Based Treatment Significantly Reduced Blood Pressure in Real-Life Practice Settings - Doctor's Guide, 10/24/05
• A Debate on the Metabolic Syndrome: Evolving Challenges and Controversies - Medscape, exp. 8/31/07 - "Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are first-line treatments for hypertensive albuminurics with the metabolic syndrome"
• Preliminary Studies Suggest Potential Metabolic Effects of Micardis (Telmisartan) - Doctor's Guide, 9/9/05 - "The Micardis molecule is structurally similar to the PPAR-gamma activator, pioglitazone,3 which has been approved for the treatment of type 2 diabetes.7 Micardis partially activates PPAR-gamma resulting in metabolic effects that differentiate it from other ARBs, according to preclinical data.1-4 These data demonstrate that Micardis has a beneficial effect on insulin resistance and blood lipids, independent of its effect on the renin-angiotensin-aldosterone system"
• Angiotensin-converting enzyme inhibitors or Angiotensin receptor blockers for prevention of type 2 diabetes a meta-analysis of randomized clinical trials - J Am Coll Cardiol. 2005 Sep 6;46(5):821-6 - "ACE inhibitors and ARBs were associated with reductions in the incidence of newly diagnosed diabetes by 27% and 23%, respectively, and by 25% in the pooled analysis ... The use of an ACE inhibitor or ARB should be considered in patients with pre-diabetic conditions such as metabolic syndrome, hypertension, impaired fasting glucose, family history of diabetes, obesity, congestive heart failure, or coronary heart disease"
• Comparison of the effects of valsartan and felodipine on plasma leptin and insulin sensitivity in hypertensive obese patients - Hypertens Res. 2005 Mar;28(3):209-14 - "These results suggest that in hypertensive obese subjects, treatment with valsartan might offer an advantage over treatment with felodipine, since valsartan may help to improve obesity-related disorders in addition to lowering BP"
• Strategies to Prevent Type 2 Diabetes - Medscape, 8/8/05 - "Valsartan reduced the incidence of new-onset diabetes by 23% ... Traditional beta-blockers worsen insulin sensitivity and increase the risk of developing new diabetes"
• FDA Approves Diovan (Valsartan) to Reduce Cardiovascular Death in Heart Attack Survivors at High Risk - Doctor's Guide, 8/4/05 - "was a rigorous comparison of Diovan vs. captopril, an ACE inhibitor, vs. the combination of both ... Diovan was reported to improve survival and reduce cardiovascular events including recurrent heart attack and hospitalizations for heart failure in these patients"
• Antihypertensive, cardiovascular, and pleiotropic effects of angiotensin-receptor blockers - Curr Opin Nephrol Hypertens. 2005 Sep;14(5):435-41 - "it has been shown that treatment with ARBs prevents the development of type 2 diabetes ... ARBs are first-line agents for the treatment of hypertension and cardiovascular diseases. Blocking the renin-angiotensin system with these agents has special advantages due to specific vascular and antiatherosclerotic effects, which contribute to a better cardiovascular and renal protection in patients at risk from or with cardiovascular disease"
• Stabilization and Regression of Albuminuria in Chinese Patients With Type 2 Diabetes: A One-year Randomized Study of Valsartan Versus Enalapril - Adv Ther. 2005 Mar-Apr;22(2):155-62 - "enalapril and valsartan both reduced blood pressure and albuminuria to a similar extent ... Fewer adverse events were reported with valsartan"
• Atacand Therapy Can Reduce Risk of Diabetes in Heart Failure Patients - Doctor's Guide, 7/4/05 - "Six percent of patients in the candesartan group were newly diagnosed with diabetes during the study period (median 3.1 year), compared to 7.4% in the placebo group"
• Effects of irbesartan on intracellular antioxidant enzyme expression and activity in adolescents and young adults with early diabetic angiopathy - Diabetes Care. 2005 Jul;28(7):1690-7 - "Adolescents and young adults with early signs of diabetic angiopathy have defective intracellular antioxidant enzyme production and activity. Treatment with irbesartan can substantially improve the activity and production of these enzymes in skin fibroblasts"
• Effects of Valsartan Compared to Amlodipine in Prevention of Type 2 Diabetes in High-Risk Hypertensive Patients: Presented at EMH - Doctor's Guide, 6/24/05 - "Valsartan is significantly superior to amlodipine for prevention of new-onset type-2 diabetes in high-risk patients with hypertension"
• Administration Time-Dependent Efficacy of Valsartan-Atorvastatin Combination in Hyperlipidaemic Patients With Essential Hypertension: Presented at EMH - Doctor's Guide, 6/22/05 - "160-mg/day dose of valsartan ... 10 mg/day of atorvastatin ... combination treatment significantly improved systolic/diastolic blood pressure levels (SBP/DBP) compared to monotherapy (17.1/10.7 vs. 13.9/9.6 mm Hg; P = .027). The same benefit was seen in terms of pulse pressure (6.4 vs. 4.3 mm Hg ... there were large significant increases in efficacy seen with the valsartan/atorvastatin combination dosed at night versus morning (SBP, 23.5 vs. 11.0 mm Hg; DBP, 15.9 vs. 6.8 mm Hg; pulse pressure, 7.8 vs. 4.1 mm Hg"
• Valsartan Significant Better Than Amlodipine for Improving Long-term Heart-rate Variability in Patients With LVH: Presented at EMH - Doctor's Guide, 6/20/05
• Irbesartan/Hydrochlorothiazide Helps Patients with Metabolic Syndrome and Poorly Controlled Hypertension: Presented at ADA - Doctor's Guide, 6/14/05
• Novartis Receives EU Marketing Authorization for Diovan to Treat People With Heart Failure - Doctor's Guide, 6/13/05
• Fixed-Dose Valsartan Gets Patients to Goal After Other Angiotensin Receptor Blocker Fixed-Dose Failures - Doctor's Guide, 5/25 - "Valsartan was deemed statistically better than either of the two initial drugs"
• Comparison of the effects of ramipril versus telmisartan in reducing serum levels of high-sensitivity C-reactive protein and oxidized low-density lipoprotein cholesterol in patients with type 2 diabetes mellitus - Am J Cardiol. 2005 Jun 1;95(11):1386-8 - "All regimens were associated with a significant reduction of C-reactive protein and oxidized low-density lipoprotein cholesterol serum levels"
• Patients Who Fail Anti-Hypertensive Monotherapy Respond to Fixed-Dose Combination of Irbesartan/Hydrochlorothiazide - Doctor's Guide, 5/19/05
• FDA Approves Atacand (Candesartan Cilexetil) For Use With An Ace Inhibitor In The Treatment Of Heart Failure - Doctor's Guide, 5/19/05
• Telmisartan Superior to Ramipril in Preventing Morning Blood Pressure Rise - Doctor's Guide, 5/19/05 - "Reductions were greater and statistically significant in the highest quartile (34 mmHg), in whom telmisartan reduced systolic surge by 12.4 mmHg and ramipril by 7.1 mmHg"
• Valsartan Reduces Chance of Diabetes in High-Risk Hypertensive Patients - Doctor's Guide, 5/19/05 - "patients taking valsartan had a 23% lower risk of developing diabetes during the four or more years of the study. The two drugs had previously been shown to be roughly equivalent in reducing the risk of heart attack and stroke" - See valsartan at OffshoreRx1.com.
• Combo Drug Controls Hypertension In Hard-to-treat Patients - Science Daily, 5/18/05 - "the combination pill of irbesartan (an angiotensin II receptor blocker) and a diuretic, hydrochlorothiazide ... the participants' systolic blood pressure (the top number) dropped an average of 21.5 points, from 154.4 to 132.9 points. Their diastolic blood pressure (the bottom number) fell an average of 10.4 points, from 91.3 to 80.9" - Yeah, but what about impotence from the diuretic?
• Bedtime Dosing of Atorvastatin and Valsartan Together Improves Overall Anti-Hypertensive Effects - Doctor's Guide, 5/17/05 - "When valsartan was dosed by itself during the day, patients averaged a 9 mmHg fall in systolic blood pressure; daytime dosing of both valsartan and atorvastatin resulted in a 17 mmHg reduction in the 24-hour mean of systolic and diastolic BP"
• Blood Pressure Linked to Erectile Dysfunction - WebMD, 5/16/05 - "Men on older high blood pressure medications (diuretics, beta-blockers) had higher rates and more severe erectile dysfunction than men on newer medications (calcium antagonists, ACE inhibitors, angiotensin II receptor blockers)"
• ACE Inhibitors or ARBs for Prevention of Type 2 Diabetes: A Meta-analysis of Randomized Clinical Trials - Medscape, 4/18/05 - "the use of valsartan reduced the incidence of new-onset type 2 diabetes by 23%"
• The Effects of Losartan Compared to Atenolol on Stroke - Medscape, 4/14/05 - "these data suggest that losartan-based treatment reduces CV complications, primarily stroke, when compared to atenolol-based treatment for patients with ISH and high CV risk"
• FDA Approves Hyzaar (Losartan Potassium-Hydrochlorothiazide) Fixed-Dose Combination - Doctor's Guide, 4/14/05
• Evidence-Based Treatment of Hypertension: What's the Role of Angiotensin II Receptor Blockers? - Medscape, 4/8/05 - "The ARBs are highly effective in lowering blood pressure and reducing cardiovascular mortality. They also appear to provide additional renal protection in patients with diabetes, and this effect is independent of their effect on blood pressure. Combinations of ARBs with drugs from other classes such as ACE inhibitors have been found to be highly effective; they may permit lower doses of ACE inhibitors to be used than in monotherapy, which may lower the incidence of dose-related adverse effects. The ARBs themselves are very well tolerated and are not associated with the side-effects known to cause compliance problems with beta blockers, ACE inhibitors and calcium channel blockers such as impotence, dry cough and peripheral oedema"
• New Data Shows Telmisartan (Micardis/Pritor) Provides Effective and Well-Tolerated Blood Pressure Lowering in Chronic Kidney Disease Patients - Doctor's Guide, 4/4/05
• Angiotensin II Receptor Blockers: A New Lease of LIFE? - Medscape, 10/26/04
• Losartan and Irbesartan Comparable in Efficacy for Blood Pressure Lowering - Doctor's Guide, 10/8/04
• Study Findings Add Further Weight to Effectiveness of Atacand (Candesartan Cilexetil) in Treating Heart Failure - Doctor's Guide, 9/3/04
• Both ACE Inhibitors and ARBs Slow Renal Decline in Type 2 Diabetes - Medscape, 8/31/04 - "the angiotensin-converting enzyme (ACE) inhibitor enalapril and the angiotensin-receptor blocker (ARB) telmisartan were equally effective in slowing kidney damage in people with type 2 diabetes, hypertension, and nephropathy"
• DETAIL Results Show Telmisartan Not Inferior to Enalapril in Renal Protection of Diabetics - Doctor's Guide, 8/31/04
• Erythema Multiforme Associated with Candesartan Cilexetil - Medscape, 7/29/04
• Antihypertensive Effect of Valsartan Appears Safely Enhanced By Doubling Conventional Dosage - Doctor's Guide, 7/9/04
• Valsartan Appears More Effective Than Telmisartan in Patients With Essential Hypertension - Doctor's Guide, 6/25/04 - "At the end of the study, the 24-hour mean BP was statistically lower in the valsartan-treated group compared to telmisartan-treated group"
• Amlodipine More Effective for Blood Pressure Reduction but Confers Similar Cardiac Outcomes to Valsartan Therapy - Doctor's Guide, 6/18/04
• Significant Reduction in Left Ventricular Mass Index, Reactive Oxygen Species Formation and C-Reactive Protein With Valsartan Treatment - Doctor's Guide, 6/18/04 - "Despite very similar effects on BP, there was a significantly higher reduction in LVMI with valsartan compared with amlodipine ... In the valsartan group, CRP levels were significantly reduced"
• Telmisartan Associated with Greater Left Ventricular Hypertrophy Regression Than Carvedilol - Doctor's Guide, 6/17/04 - "The angiotensin II receptor blocker telmisartan produces significantly greater left ventricular hypertrophy (LVH) regression than does the beta blocker carvedilol in hypertensive patients"
• Newer Drug Helps Prevent Heart Attack - HealthDay, 6/17/04 - "people taking valsartan had much lower rates of admission to hospital for heart failure. And fewer people in the valsartan group (13 percent) developed type 2 diabetes than those in the amlodipine group (16 percent)"
• Telmisartan 40 or 80 mg/Hydrochlorothiazide 12.5 mg Fixed –Dose Combinations Can Thwart Early Morning Blood Pressure Surge - Doctor's Guide, 6/15/04
• Benicar (Olmesartan Medoxomil) and Benicar HCT (Olmesartan Medoxomil/Hydrochlorothiazide) Therapies Achieve Blood Pressure Goals in Hypertension - Doctor's Guide, 5/26/04 - "at the usual recommended starting doses, approximately twice as many patients treated with Benicar achieved goal blood pressure of less than 140/90 mm Hg compared to Cozaar®(losartan potassium) and Diovan® (valsartan), the two most commonly prescribed angiotensin II receptor blockers (ARBs)"
• Maximum Dose of Valsartan Appears More Effective than Telmisartan in Lowering Ambulatory Blood Pressure and Pulse Pressure Over 24 hours - Doctor's Guide, 5/25/04 - "the blood pressure reduction in the 24-hour mean was significantly larger for valsartan 160 mg (18.6 and 12.1 mm Hg for systolic and diastolic blood pressure, respectively) than for telmisartan 80 mg (10.8 and 8.4 mm Hg"
• Losartan Preserves Cerebral Blood Flow in Hypertensive Patients With a History of Stroke - Doctor's Guide, 5/19/04
• Atacand (Candesartan Cilexetil) Appears More Effective Than Cozaar (Losartan) at Lowering Blood Pressure - Doctor's Guide, 5/10/04 - "Candesartan was shown to lower systolic and diastolic blood pressure by 2 to 3 mm Hg on average more than losartan potassium when measured at the time of either peak or trough effect"
• Valsartan May Produce Lower Ambulatory Heart Rate, Greater Lowering of Daytime Systolic Blood Pressure than Amlodipine in Elderly Patients with Systolic Hypertension - Doctor's Guide, 5/6/04
• Telmisartan Safe, Effective for the Treatment of Isolated Systolic Hypertension - Doctor's Guide, 5/4/04
• Left Ventricular Mass Index Reduced with Low-Dose Valsartan in Patients with Type 2 Diabetes - Doctor's Guide, 4/15/04
• Telmisartan Lowers Early Morning Blood Pressure in Patients With Hypertension More Effectively Than Does Valsartan - Doctor's Guide, 4/12/04 - "telmisartan reduced BP during the last 6 h of the dosing period more effectively than did valsartan (-11/-7.6 +/- 0.8/0.6 mm Hg vs. -8.7/-5.8 +/- 0.8/0.6 mm Hg"
• Losartan-Based Treatment Appears More Effective In Reducing Strokes In Hypertensives Than Atenolol-Based Treatment - Doctor's Guide, 4/1/04
• Telmisartan Safe, Effective for Treatment of Hypertension in a Diverse Population - Doctor's Guide, 3/5/04
• Irbesartan More Cost and Survival Effective than Amlodipine in Canadian Patients with Diabetic Neuropathy and Hypertension - Doctor's Guide, 3/4/04
• Telmisartan Appears to Offer Additional Benefit to Antihypertensive Regimens - Doctor's Guide, 1/22/04
• ARB, ACE Inhibitor, or Both After MI in High-Risk Patients? - Medscape, 1/9/04
• Telmisartan Reduces Blood Pressure and Left Ventricular Mass Index in Patients with Hypertension - Doctor's Guide, 1/7/04 - "Telmisartan was significantly more effective in reducing blood pressure and left ventricular mass index (LVMI) than was hydrochlorothiazide in patients with mild-to-moderate hypertension ... Reducing LVM is a primary objective to managing hypertension because of the increased risk of cardiovascular morbidity and mortality associated with increases in LVM"
• Reduction in Left Ventricular Mass Due to Irbesartan Correlates With Increased Angiotensin II Levels - Doctor's Guide, 12/9/03
• Persistent Renoprotection After Irbesartan Withdrawal in Hypertensive Type 2 Diabetics - Doctor's Guide, 11/18/03
• Teveten (Eprosartan Mesylate) Effectively Lowers Systolic Blood Pressure, Pulse Pressure in Isolated Systolic Hypertension - Doctor's Guide, 11/14/03
• Valsartan Shown as Effective as Captopril for Post-Heart Attack Treatment - Doctor's Guide, 11/10/03
• Two Heart Drugs [ARBs & ACE Inhibitors] Found Equally Effective - HealthDay, 11/10/03 - "Overall survival in both groups and among patients who got combined therapy was better than 80 percent ... The incidence of side effects such as cough, taste disturbance and rash was higher among those given both drugs together, and people getting the combined treatment were more likely to stop taking the medications ... valsartan is "a safe and equally effective alternative" for patients who have problems with ACE inhibitor treatment, Mann writes. People with kidney problems, for instance, are usually kept away from these drugs"
• Irbesartan More Effective Than Amlodipine in Reducing Left Ventricular Mass Index - Doctor's Guide, 11/4/03 - "Several studies have established that LVH is a powerful BP-independent cardiovascular risk factor; however, not all antihypertensive drugs can reverse LVH ... After 3 months, echocardiographically estimated LVMI decreased by 23.2% in the irbesartan-treated patients and 11.4% in the amlodipine-treated patients"
• Losartan Improves Cognitive Function in Elderly Hypertensive Patients - Doctor's Guide, 10/31/03 - "Patients receiving losartan showed significant improvement in both memory tests, while those receiving atenolol did not shown a difference with treatment. Losartan treatment was associated with a 2.2 point increase in word list memory score and a 2.1 point increase in the word list recall score ... Notably, a greater number of adverse events were reported in patients given atenolol than in those given losartan (31 vs. 8 events)"
• Telmisartan And Lisinopril Appear Equally Effective In Reducing Blood Pressure and Pulse Pressure - Doctor's Guide, 10/10/03 - "For both TPR and SI measurement techniques, no differences were detected between the two drugs in their effects on systolic and diastolic BP"
• Renin-Angiotensin System Blockade Produces Multiple Benefits Independent of Blood Pressure Reduction - Doctor's Guide, 9/29/03 - "According to the authors, ACE inhibitors and ARBs, at least in higher- or moderate-risk individuals, "show advantages that are additional to the reduction in blood pressure that they achieve ... We still await new and forthcoming data as to whether the better-tolerated ARBs have benefits equivalent to those of the ACE inhibitors, for which there are now numerous data ... We also await data on the combination of both these classes of drugs, particularly with respect to safety"
• Candesartan More Effective Than ACE Inhibition Post-Myocardial Infarction - Doctor's Guide, 9/29/03
• Losartan Reduces Hospitalizations in Diabetic Heart-Failure Patients - Doctor's Guide, 9/29/03
• Drugs Blocking the Renin-Angiotensin System Offer Advantages Beyond Lowering Blood Pressure - Doctor's Guide, 9/15/03 - "According to the authors, ACE inhibitors and ARBs, at least in higher- or moderate-risk individuals, "show advantages that are additional to the reduction in blood pressure that they achieve"
• High Doses of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Required for Maximum Renoprotection - Doctor's Guide, 9/12/03 - "angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can have significant renoprotective effects, in addition to known antihypertensive benefits ... The optimal dose and strategy for renoprotection using ACEI and ARBs should be guided by titrating to the maximum antiproteinuric effect ... For patients who maintain elevated proteinuria despite high dose monotherapy, they recommend combined use of ACE inhibitors and ARBs"
• Brain Natriuretic Peptide Changes Are Predictive of Valsartan Treatment Success in Heart Failure - Doctor's Guide, 9/9/03
• CHARM Trials Demonstrate Add-On Benefit of Candesartan for Heart Failure - Doctor's Guide, 9/3/03
• Effect of losartan on sudden cardiac death in people with diabetes: data from the LIFE study - Lancet. 2003 Aug 23;362(9384):619-20 - "In the losartan group, five (6%) of 86 patients with diabetes and atrial fibrillation during the trial died of sudden cardiac death compared with nine (2%) of 500 in those without atrial fibrillation. The respective figures for the atenolol group were 14 (13%) of 105 and 16 (3%) of 504. Our results suggest losartan affords better protection against cardiac death from arrhythmias for patients with diabetes mellitus than does atenolol"
• Renin-Angiotensin System Blockers Offers Added Benefits Beyond Blood-Pressure Lowering For Hypertensives - Doctor's Guide, 8/28/03 - "Emerging data on newer drugs that block the renin-angiotensin system, such as the angiotension II type 1 receptor blockers (ARBs) and angiotension-converting enzyme (ACE) inhibitors, indicate added benefits such as reduced mortality, strokes, and myocardial infarction along with decreased blood pressure"
• Losartan Superior to Atenolol For Reducing Cardiac Death From Arrhythmias In Hypertensive Diabetics - Doctor's Guide, 8/21/03
• Losartan More Effective Than Atenolol in Preventing Morbidity and Mortality in Low-Risk Hypertensive Patients - Doctor's Guide, 8/21/03 - "Losartan appears to be more effective than atenolol in preventing cardiovascular morbidity and death - especially fatal and non-fatal stroke - in patients with hypertension but without clinically evident vascular disease. Furthermore, the effect appears to be independent of blood pressure reduction ... In addition, incident diabetes occurred less often in patients treated with losartan"
• Losartan Causes Greater Regression of Left Ventricular Hypertrophy Compared to Atenolol - Doctor's Guide, 8/8/03
• Early Intervention with Atacand (Candesartan) Improves Outcome for Patients with Acute Ischaemic Stroke - Doctor's Guide, 7/28/03
• ACE Inhibitors Prevent Diabetes and Cardiovascular Disease by Multiple Mechanisms - Doctor's Guide, 7/25/03 - "ACE inhibitors inhibit the conversion of angiotensin I to angiotensin II ... Angiotensin II increases the production of reactive oxygen species and has several vasoconstrictive effects, including opposition of the vasorelaxant actions of nitric oxide and stimulation of plasminogen activator inhibitor-1 ... Angiotensin II, furthermore, increases arterial stiffness by a variety of mechanisms ... fewer studies have evaluated the effects of angiotensin receptor blockers (ARBs), although these agents may also exert beneficial effects and may act synergistically with ACE inhibitors ... The authors note that, regarding the role of ACE inhibitors in diabetic renal disease, with the exception of ARBs, ACE inhibitors "have been shown to be more effective in reducing proteinuria than any other antihypertensive agents."
• Telmisartan Effective and Well-tolerated for Renal Failure Patients - Doctor's Guide, 6/20/03
• FDA Grants Marketing Approval for Benicar HCT (Olmesartan Medoxomil-Hydrochlorothiazide) Treatment For Hypertension - Doctor's Guide, 6/9/03
• Fenofibrate, Losartan Show Additive Benefits with Anti-hyperuricaemic Agents in Gout Patients - Doctor's Guide, 6/4/03
• Telmisartan Improves Quality of Life Measurements in Hypertensive Patients - Doctor's Guide, 5/30/03 - "The angiotensin II receptor blocker telmisartan appears to enhance the quality of life for patients who are being treated for high blood pressure ... the scores increased from 77 at baseline to an average of 82.2"
• Losartan Treatment Effect is Boosted by DASH Diet - Doctor's Guide, 5/26/03 - "For patients receiving losartan, systolic and diastolic blood pressure was significantly reduced from baseline on the control diet (-6.7 + 1.5/-3.7 + 1.0 mm Hg, P < .05), with an even greater effect evident for the DASH diet (-1.7 + 1.5/-6.9 + 1.0 mm Hg, P < .05) ... A reduction in systolic blood pressure in patients receiving placebo occurred on the DASH diet (-5.3 + 1.5 mm Hg, P < .05). No other significant changes to blood pressure levels were observed" - [Abstract]
• Angiotensin II Receptor Blockers Effective, Better Tolerated than Calcium Channel Blockers in Elderly Patients - Doctor's Guide, 5/21/03 - "Valsartan and amlodipine are both highly effective in controlling blood pressure in patients with isolated systolic hypertension ... However, valsartan offers a significant tolerability advantage as it shows a reduced risk of developing adverse events"
• Olmesartan Medoxomil Has Equal Efficacy and Safety in Hypertensive Men and Women - Doctor's Guide, 5/21/03
• Hypertensive Patients Respond to Telmisartan Titration in Community-Based Trial - Doctor's Guide, 5/20/03
• Eprosartan Mesylate Shows Benefits in Elderly with Isolated Systolic Hypertension - Doctor's Guide, 5/20/03
• Valsartan Appears to Improve Sexual Function in Men and Women with Hypertension - Doctor's Guide, 5/18/03 - "Men and women being treated with the angiotensin II receptor blocker valsartan for mild-to-moderate hypertension appear to show improvements in sexual function and desire"
• Patients Respond to Up-titration of Olmesartan - Doctor's Guide, 5/18/03
• Candesartan Effectively Reduces Blood Pressure in Elderly Hypertensives - Doctor's Guide, 5/12/03 - "Active anti-hypertensive treatment was given to most patients (84%) in the control group ... A first major cardiovascular event occurred in 242 candesartan patients and in 268 controls. The risk reduction with candesartan was 10.9%. Candesartan-based treatment reduced non-fatal stroke by 27.8% and all stroke by 23.6%" - [Abstract]
• Eplerenone Superior To Losartan In Black Patients With Hypertension - Doctor's Guide, 4/14/03
• Candesartan Improves Congestive Heart Failure - Doctor's Guide, 4/11/03
• LIFE Sub-Study Finds Losartan Superior To Atenolol In Atrial Fibrillation - Doctor's Guide, 4/4/03
• Basal Nitric Oxide Production, Release Improved By AT(1) Receptor Blockade With Valsartan - Doctor's Guide, 2/19/03
• Which Blood Pressure Drug Is Best? - HealthDay, 2/12/03
• Amlodipine Appears To Provide Greater Reduction In Blood Pressure Than Does Losartan - Doctor's Guide, 2/6/03 - "Diastolic blood pressure equal to or below 90 mm Hg was achieved by 43.6% of the amlodipine patients and 42.3% of the losartan patients. Seventy-one percent of the amlodipine and 81% of the losartan patients who continued treatment with the original dose reached blood pressure goals ... However, among those patients who required dosage adjustments, a significantly higher number of amlodipine patients reached blood pressure goals. Fifty-nine percent of the amlodipine patients compared with 42%"
• BP Drug Cozaar Also Prevents Stroke - WebMD, 1/7/03 - "Cozaar reduced the risk of stroke by about 25% compared with atenolol"
• FDA Advisors Recommend Losartan for Stroke Prevention - Medscape, 1/7/03
• Averting Migraines With Few Side Effects - WebMD, 12/31/02
• Valsartan Improves Augmentation Index In Essential Hypertension - Doctor's Guide, 12/23/02
• BP Lowering May Halt Descent Into Dementia - Clinical Psychiatry News, 12/02 - "those in the candesartan arm had a mean 0.5-point decline in MMSE scores during follow-up, compared with a 6-point drop in those on a diuretic. The cognitive benefit was even more pronounced in patients over age 85"
• Irbesartan Improves Cardiac Repolarization In Hypertensive Left Ventricular Hypertrophy - Doctor's Guide, 11/26/02
• Telmisartan Efficacy in Mild-Moderate Hypertension Confirmed - Doctor's Guide, 11/25/02
• Valsartan Produces Sustained Aldosterone Decrease in Heart Failure Patients - Doctor's Guide, 11/18/02
• Losartan Reduces Proteinuria in Non-Diabetic Patients with Nephropathy - Doctor's Guide, 11/7/02
• Angiotensin Receptor Blocker Plus Angiotensin Converting Enzyme Inhibitor Enhances Angiotensin II Blocking Effect - Doctor's Guide, 11/4/02
• Albumin Secretion, Blood Pressure Lowered by Angiotensin II Receptor Blocker Telmisartan - Doctor's Guide, 11/1/02
• Incidence of Cardiac Events Similar Between Amlodipine And Irbesartan in Diabetic Patients with Overt Nephropathy - Doctor's Guide, 11/1/02
• Angiotensin II Receptor Blockers Reduce Proteinuria In Lupus Nephritis - Doctor's Guide, 10/29/02
• New Angiotensin II Blocker Counters Hypertension Effectively And Safely - Doctor's Guide, 10/22/02
• Valsartan Improves Survival, Reduces Hospitalisations In Heart Failure Patients Not Taking Ace Inhibitors - Doctor's Guide, 10/16/02
• Valsartan's Benefit in Heart Failure Confirmed - Doctor's Guide, 10/4/02
• Candesarten Effectively Reduces Proteinuria in Patients with Chronic Glomerulonephritis - Doctor's Guide, 10/1/02
• Losartan Superior in Isolated Systolic Hypertension with Left Ventricular Hypertrophy - Doctor's Guide, 9/25/02
• Losartan Better Than Atenolol at Reducing Cardiovascular Risk - Medscape, 9/25/02
• FDA Approves Avapro (Irbesartan) For The Treatment Of Diabetic Nephropathy (Kidney Disease) In Patients With High Blood Pressure And Type 2 Diabetes - Doctor's Guide, 9/18/02
• Lisinopril But Not Losartan Boosts Myocardial Perfusion In Hypertensives With Left Ventricular Hypertrophy - Doctor's Guide, 9/18/02
• LIFE Substudy Shows Losartan Superior to Atenolol at Reducing Stroke Risk - Doctor's Guide, 9/16/02
• Losartan Superior To Atenolol In Reducing Left Ventricular Hypertrophy In Hypertensives - Doctor's Guide, 9/4/02
• Losartan Reduces Incidence of End-Stage Renal Disease in Type 2 Diabetics, Also Lowers Cost Burden - Doctor's Guide, 9/4/02
• New Data From Val-HeFT Shows Diovan (Valsartan) Is Highly Cost-Effective In Treating Heart Failure Patients Not Taking ACE Inhibitors - Doctor's Guide, 9/2/02
• FDA Approves Blood Pressure Treatment Diovan(R) (valsartan) for Heart Failure - Doctor's Guide, 8/15/02
• Lercanidipine and Losartan Effective, Well-Tolerated Monotherapies for Mild to Moderate Hypertension - Doctor's Guide, 8/13/02
• Low Dose Valsartan Therapy May Reduce Urinary Albumin Excretion In Type 2 Diabetics With Nephropathy - Doctor's Guide, 7/31/02
• Patient Compliance with Antihypertensive Therapy Appears Longer for Those Taking Angiotensin II Antagonists - Doctor's Guide, 7/18/02 - "The researchers found that the class of drug had a statistically significant effect on the patients' persistence of compliance. Angiotensin II antagonists had the highest rate of persistence followed by ACE inhibitors, calcium channel blockers, beta-blockers, and diuretics"
• Antiproteinuric Effect of Losartan Related to its Haemodynamic Effects - Doctor's Guide, 7/18/02
• Cozaar (Losartan) Lowered Risk Of Total Mortality In Patients With Diabetes By 39% Versus Atenolol - Doctor's Guide, 6/27/02 - "treatment with losartan resulted in a 24 per cent reduction in the primary composite endpoint of cardiovascular death, stroke and heart attack compared to the beta-blocker atenolol (p=0.03). Blood pressure and pulse pressure reductions were similar with both therapies. In addition, losartan significantly reduced the risk of cardiovascular death by 37 per cent (p=0.03) and total mortality by 39 per cent ... A 39 per cent reduction in total mortality with losartan is an important observation given that the observed reduction is versus an established antihypertensive, atenolol ... It is widely accepted that elevated systolic blood pressure is an even stronger risk factor for cardiovascular events than diastolic blood pressure"
• Reducing Hypertension In The Elderly Leads To A Significant Reduction In The Incidence Of Stroke - Doctor's Guide, 6/27/02
• Losartan Plus Hydrochlorothiazide Reduces Essential Hypertension - Doctor's Guide, 6/26/02
• Severe Fibrosis Appears To Decrease Following Losartan Therapy - Doctor's Guide, 6/6/02
• Antihypertensive persistence and drug class - Can J Cardiol. 2002 Jun;18(6):649-56 - "Angiotensin II antagonists had the highest persistence followed by angiotensin-converting enzyme inhibitors, calcium channel blockers, beta-blockers and diuretics"
• Results Published Demonstrate that Irbesartan Provides Greater Blood Pressure Reduction than Valsartan in Patients with Elevated Blood Pressure - Doctor's Guide, 5/24/02
• Losartan Restores Normal Dilation Of The Left Main Coronary Artery After Cold Pressor Test - Doctor's Guide, 5/23/02
• Irbesartan More Effective than Atenolol in Reducing Cardiac Electrical Instability - Doctor's Guide, 5/20/02
• Impotent Patients on Valsartan Find Increased Interest in Sex; Use Sildenafil More Often - Doctor's Guide, 5/19/02 - "Because the use of sildenafil significantly increased with the use of valsartan, it suggests that angiotensin II antagonism induces an increase in sexual desire in impotent hypertensive men ... It could be related to the reactive stimulation of angiotensin cascade due to AT1 receptors blockade"
• VALUE trial Shows Lower Diastolic Blood Pressure After One Year in 90% of Patients - Doctor's Guide, 5/19/02
• Olmesartan Medoxomil and Amlodipine Equally Effective for Mild to Moderate Hypertension - Doctor's Guide, 5/19/02
• Eplerenone Appears Superior to Losartan in Salt-Sensitive Hypertensive Patients - Doctor's Guide, 5/19/02
• Losartan Reduces Platelet Activity When Compared to Candesartan in Patients With Diabetes and Hypertension - Doctor's Guide, 5/17/02
• Results of a New Study Show That Irbesartan May Provide Additional Benefits For High Risk Patients With High Blood Pressure - Doctor's Guide, 5/16/02
• Telmisartan/Hydrochlorothiazide Combination Superior To Telmisartan Alone For Hypertension - Doctor's Guide, 5/13/02
• FDA Grants Marketing Approval For Benicar (Olmesartan Medoxomil) For Treatment Of Hypertension - Doctor's Guide, 4/26/02 - "is a member of the rapidly growing angiotensin II receptor blocker (ARB) class ... Studies have shown that Benicar 20 mg once a day, the recommended starting dose, resulted in double-digit blood pressure reduction, lowering systolic blood pressure by an average of 15mm Hg* and diastolic blood pressure by an average of 12mm Hg. In these studies, patients receiving placebo had average reductions in systolic blood pressure of 5.6 mm Hg and in diastolic blood pressure of 6.2mm Hg."
• Losartan Reduces QT Dispersion In Patients With Mild To Moderate Hypertension - Doctor's Guide, 4/16/02
• Combination ACE Inhibitors and Angiotensin II Blockers Decreases Proteinuria in Patients with Diabetic Nephropathy - Doctor's Guide, 4/11/02
• Diabetic Hypertensives Benefit More From Losartan Than Atenolol - Doctor's Guide, 3/22/02
• Drug for high blood pressure reduces diabetes risk - USA Today, 3/21/02 - "using the drug Cozaar to treat people with high blood pressure reduces their risk of developing diabetes by 25%"
• LIFE Study Finds Losartan More Effective than Atenolol in Hypertensive Patients - Doctor's Guide, 3/20/02
• A Better Blood-Pressure Drug [Cozaar] - WebMD, 3/20/02
• Morbidity Risk Reduced When Valsartan Administered In Hypertensive Heart Failure - Doctor's Guide, 3/19/02
• Losartan/Quinapril Combination Therapy Suppresses Cardiac Sympathetic Activity - Doctor's Guide, 1/29/02
• Eprosartan Reduces Blood Pressure Throughout 24 Hours - Doctor's Guide, 12/27/01
• Support Qualified For Valsartan In Chronic Heart Failure - Doctor's Guide, 12/6/01
• New Data Support Early Intervention With Atacand (Candesartan Cilexetil) In Acute Ischaemic Stroke - Doctor's Guide, 12/6/01
• Stroke Patients Show Significant Risk Reduction When Given Atacand (Candesartan Cilexetil) - Doctor's Guide, 11/29/01
• Diovan (Valsartan) Reduces Total Heart Failure Hospitalizations - Doctor's Guide, 11/13/01
• Diovan (Valsartan) Significantly Reduces Marker of Heart Failure Severity - Doctor's Guide, 11/12/01
• FDA Issues Approvable Letter For Diovan (Valsartan) For Treatment Of Heart Failure - Doctor's Guide, 10/25/01
• Losartan Cuts Costs of Kidney Failure and Incidence of End-Stage Renal Disease in Diabetics - Doctor's Guide, 10/17/01
• Avapro (Irbesartan) Effectively Stops Progression of Type 2 Diabetic Nephropathy - Doctor's Guide, 10/17/01
• Long-term Irbesartan, Amlodipine Normalizes Resistance Artery Structure and Endothelial Function - Doctor's Guide, 9/25/01
• Blood Pressure Drug May Help Kidneys - Intelihealth, 9/20/01 - "Doctors found that the medicines, called angiotensin II receptor blockers, forestall complete kidney failure by about two years in diabetics with advanced kidney disease. They predict the effects will be even more dramatic in those with less severe kidney damage, potentially protecting them from ever reaching end-stage disease ... If the data keep getting stronger, it will become a recommendation, because there is very little downside to these drugs ... Angiotensin blockers have fewer side effects than ACE inhibitors, which cause a cough in about 20 percent of users"
• Cozaar (Losartan) Slows Progression of Kidney Disease in Type 2 Diabetes - Doctor's Guide, 9/19/01
• Irbesartan Protects Against Kidney Disease Progression in Hypertension, Type 2 Diabetes - Doctor's Guide, 9/4/01
• Blood pressure drug reverses sexual dysfunction - Life Extension Magazine, 7/01 - "the active ingredient in Cozaar and Hyaar (losartan) can significantly improve sex lives of men who suffer from sexual dysfunction"
• Low-Dose Perindopril/Indapamide Combination More Effective Than Irbesartan Alone - Doctor's Guide, 6/21/01
• Long-Term Compliance to Losartan Superior To Other Antihypertensives - Doctor's Guide, 6/20/01
• Telmisartan Effective And Well-Tolerated In Long-Term Treatment Of Hypertension - Doctor's Guide, 6/20/01
• Candesartan Shown Equivalent To Enalapril In Regressing Left Ventricular Hypertrophy - Doctor's Guide, 6/19/01
• Irbesartan Delays Nephropathy In Diabetic Patients - Doctor's Guide, 6/17/01
• Better Compliance Found With Once Daily Irbesartan Over Atenolol in Treatment of Pediatric Severe Hypertension - Doctor's Guide, 5/30/01
• Cozaar (Losartan) Significantly Reduces Progression of Kidney Disease in Type 2 Diabetics - Doctor's Guide, 5/24/01
• Diabetics Get Kidney Protection From ARBs, High Blood Pressure Drugs Reduce Need for Dialysis, Transplant - WebMD, 5/20/01 - "results from three landmark studies of almost 4,000 diabetic patients suggest that a specific class of blood pressure drugs called angiotensin receptor blockers, or ARBs, can protect kidneys and reduce the need for kidney dialysis or transplant"
• Irbesartan Slows Kidney Disease In Diabetics - Doctor's Guide, 5/20/01
• Telmisartan With Hydrochlorithiazide Controls Hypertension - Doctor's Guide, 5/18/01 - "after eight weeks on the FDC, both SBP/DBP dropped by 7.4/3.5 mmHg, compared with the telmisartan 40 mg monotherapy"
• Diovan (Valsartan) Effective in Reducing Microalbuminuria - Doctor's Guide, 5/17/01 - "Diovan® (valsartan), is more effective in reducing microalbuminuria (p<0.001), an early sign of diabetic kidney disease, compared to the calcium channel blocker, amlodipine"
• Newest Hypertension Drug, Losartan, May Improve Sexual Function - Doctor's Guide, 5/1/01
• Angiotensin II Antagonist Telmisartan Fights Stiffening Arteries In Hypertensive Diabetics - Doctor's Guide, 4/6/01 - "not only effectively lowered blood pressure compared with placebo, but also significantly decreased arterial stiffness"
• Angiotensin II Antagonist Plus Conventional Treatment Improves Blood Pressure Control, Kidney Function - Doctor's Guide, 4/6/01 - "Adding candesartan cilexetil to conventional therapy significantly reduced albuminuria by a mean of 25 percent, fractional albumin clearance by a mean of 35 percent, 24-hour systolic blood pressure by a mean of 10 mmHg, and GFR by a mean of 5 ml/minute/1.73 m2. The mean reduction in diastolic blood pressure (3 mmHg) was not statistically significant"
• Carvedilol Reduces But Valsartan May Increase Sexual Activity In Hypertensive Men - Doctor's Guide, 2/1/01 - "carvedilol induces a chronic reduction of sexual activity whereas valsartan, an angiotensin II antagonist, not only does not significantly reduce sexual activity but may even increase it."
• FDA Approves Micardis HCT (Telmisartan/Hydrochlorothiazide) For Hypertension - Doctor's Guide, 11/21/00 - "Micardis HCT 80/12.5 mg significantly reduced diastolic and systolic blood pressures by an average of 14.9 mmHg and 23.9 mmHg, respectively"
• Triple Therapy Including Angiotensin Blockers Shows Benefits In Heart Failure Treatment - Doctor's Guide, 11/21/01 - "This finding contradicts the long-held belief that the drugs should not be combined, and means it may be possible to use a form of "triple therapy" for some congestive heart failure patients"
• Valsartan Provides Significant Reduction In Combined Risk Of Death, Morbidity From Heart Failure - Doctor's Guide, 11/15/00
• Atacand HCT (Candesartan Cilexetil-Hydrochlorothiazide), Anti-Hypertensive, Now Available In US - Doctor's Guide, 10/26/00
• Angiotensin-converting Enzyme Inhibitors, Beta Blockers May Postpone Kidney Failure - Doctor's Guide, 10/13/00
• FDA Approves Atacand HCT (Candesartan Cilexetil HCl) For Hypertension - Doctor's Guide, 9/6/00
• Irbesartan Improves Quality Of Life In Hypertensives - Doctor's Guide, 8/24/00 - "although the use of antihypertensive drugs before inclusion of irbesartan appeared to make quality of life worse, the addition of irbesartan produced a positive impact on quality of life"
• Enalapril And Losartan Reverse Arterial Vessel Stiffening - Doctor's Guide, 8/24/00
• Valsartan And Warfarin May Be Co-administered Safely - Doctor's Guide, 8/24/00
• Candesartan/Lisonopril Combination Decreases Blood Pressure In Diabetics - Doctor's Guide, 8/23/00 - "The effect of combination therapy was much more than could be achieved by doubling the dose of each of the drugs separately"
• Olmesartan Decreases Plasma Angiotensin II Levels - Doctor's Guide, 8/22/00 - "Olmesartan was able to significantly decrease both the systolic and diastolic blood pressure in healthy adults to an average of 136/84 mm Hg [from 164/100 mm Hg]"
• Valsartan Effectively Lowers Blood Pressure in African Americans on High-Salt Diets - Doctor's Guide, 7/18/00
• Atacand (Candesartan Cilexetil) Significantly More Effective Than Cozaar (Losartan) In Lowering Blood Pressure - Doctor's Guide, 7/11/00 - "the use of Atacand at the maximum once-daily dose of 32 mg reduced trough sitting diastolic blood pressure (DBP) by 10.9 mm Hg and trough sitting systolic blood pressure (SBP) by 13.3 compared to 8.7 mm Hg and 9.8 mm Hg for the once-daily maximum dose of 100 mg losartan. In the second CLAIM Study, Atacand 32 mg reduced DBP by 10.5 mm Hg and SBP by 13.4 mm Hg compared to 9.1 mm Hg and 10.1 mm HG for 100 mg losartan"
• Atacand(Candesartan) Effective Antihypertensive, More Tolerable Than Norvasc(Amlodipine) - Doctor's Guide, 5/19/00 - "The angiotensin II receptor blocker (ARB) Atacand® (candesartan cilexetil) demonstrated similar efficacy in lowering blood pressure with significantly less swelling in patients' feet and ankles compared to the most prescribed antihypertensive medication, the calcium channel blocker Norvasc® (amlodipine, Pfizer)"
• Diovan (Valsartan) Reduces Systolic Hypertension In The Elderly - Doctor's Guide, 3/3/00
• Losartan Doesn’t Unseat Reigning Therapy For Heart Failure - Doctor's Guide, 11/11/99 - "The angiotensin II receptor blocker losartan (Cozaar) did not outperform gold-standard ACE inhibitor therapy in the treatment of heart failure in a large, randomized trial, following a smaller trial that suggested it might be more effective."
• Antihypertensive Teveten Tablets Now Available In The U.S. - Doctor's Guide, 10/18/99
• Avalide Available In U.S. For High Blood Pressure Treatment - Doctor's Guide, 5/13/99 - "(irbesartan/hydrochlorothiazide tablets)"
• Micardis Available In U.S. For Hypertension - Doctor's Guide, 2/22/99
• Atacand Available In U.S. For Hypertension - Doctor's Guide, 10/20/98 - "One of the advantages of a medication like Atacand is that the overall incidence of side effects is similar to placebo"
• FDA-Approved Diovan HCT Combines Two Hypertension Drug Classes - Doctor's Guide, 3/10/99
• FDA Advisory Panel Recommends Approval of Verdia For Hypertension - Doctor's Guide, 1/28/98
• New Drug [PrDiovan(tm) (valsartan) Puts The Brakes On Hypertension - Doctor's Guide, 12/2/97
• Diovan Reduces Left Ventricular Hypertrophy - Doctor's Guide, 7/17/97
• Diovan For First-Line Treatment of Hypertension Cleared by FDA - Doctor's Guide, 12/26/96