New blood pressure drug Micardis (Telmisartan) good at reducing deaths from heart attacks

Apr 1 2008

An international team of researchers have found that a new blood pressure medication is as effective in reducing cardiovascular death, with fewer side effects than the current treatments offered.

The new blood pressure drug Micardis or Telmisartan, has been found to be as effective as the popular ACE inhibitor Ramipril in reducing cardiovascular death in high risk patients and it has fewer side effects.

According to Dr. Salim Yusuf of McMaster University in Ontario, Canada, for those patients who cannot tolerate ACE inhibitors, Telmisartan offers another alternative.

Both Telmisartan and Ramipril act on a compound called angiotensin, but they do it in different ways; Telmisartan is an angiotensin receptor blocker (ARB) while Ramipril is an angiotensin converting enzyme, or ACE, inhibitor.

The research team conducted a study comparing the drugs in more than 25,620 patients, at 733 centers in 40 countries, who collaborated in the ONTARGET study.

The patients had coronary heart disease or diabetes plus additional risk factors and were all over the age of 55 years of age, but did not have evidence of heart failure.

The patients were randomly chosen to receive 10-mg Ramipril a day, or 18-mg of Telmisartan a day or the combination of the two; the follow-up period was more than four and a half years.

The researchers found that both Telmisartan and Ramipril worked equally well to reduce cardiovascular death, stroke, heart attack or hospitalization for heart failure, but Telmisartan was easier to tolerate than Ramipril and fewer patients experienced coughing or other side effects.

Though Micardis is the first ARB to be shown to have heart benefits in patients who do not have heart disease, the drug is more expensive than typical ACE inhibitors, which may affect how often it is used.

The study says for this reason it may not change current practice.

Experts say as the same results can be achieved with an ACE inhibitor, most physicians will choose the drugs that are generically available.

The researchers also tested Micardis in combination with an ACE inhibitor, but found the combination caused a number of negative side-effects in patients who did not have heart failure.

Dr. Yusuf says doctors will need to be careful not to use both drugs in patients as putting the two together could cause harm.

Dr. Koon Teo, professor of medicine at McMaster University and head of clinical trials in the Population Health Research Institute at Hamilton Health Sciences, says the trial is very important because conditions such as heart attack, stroke, heart failure, cardiovascular death and diabetes. affect millions of people around the world and better treatments, which improve outcomes, can only be good.

The study was presented at a meeting of the American College of Cardiology in Chicago and is published online in the New England Journal of Medicine.