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Telmisartan Associated with Greater Left Ventricular Hypertrophy Regression Than Carvedilol: Presented at ESH

By Jill Stein

PARIS, FRANCE -- June 17, 2004 -- The angiotensin II receptor blocker telmisartan produces significantly greater left ventricular hypertrophy (LVH) regression than does the beta blocker carvedilol in hypertensive patients, according to study findings.

Presenting data on June 14th at the 14th meeting of the European Meeting on Hypertension, Domenico Galzerano, MD, from San Gennaro Hospital in Naples, Italy, said that the findings suggest that telmisartan provides an important mechanism beyond lowering blood pressure in producing LVH regression in hypertensive patients. "The greater LVH regression achieved with telmisartan may translate into improvements in the risk reduction for cardiovascular events," he added.

Researchers recruited 82 patients with mild to moderate hypertension and LVH to participate in the double-blind study. The patients were randomised to treatment with either telmisartan 80 mg or carvedilol 25 mg once daily for 44 weeks. No other antihypertensive treatment was allowed for the duration of the study.

Both drugs were well tolerated. Ten patients withdrew from the study because their diastolic blood pressure remained greater than 90 mm Hg, and 2 patients withdrew because of dizziness.

Significant reductions in 24-hour mean systolic and diastolic blood pressure were achieved with both telmisartan (P <.001) and carvedilol (P <.001) after treatment for 44 weeks.

The systolic blood pressure reduction achieved with telmisartan was 30.9 ± 9.0 mm Hg versus 28.7 ± 9.1 mm Hg with carvedilol. The difference between the 2 groups was not statistically significant.

The diastolic blood pressure decrease with telmisartan was 19.0 ±9.0 mm Hg, and the reduction achieved with carvedilol was 17.1 ±5.0 mm Hg. The difference between the 2 groups was not significant.

The results of 3-dimensional echocardiography showed that both drugs significantly reduced LV mass index after 44 weeks of treatment, P <.0001.

In telmisartan-treated patients, LV mass index was reduced by 21.9 ±5.9 g/m², which represents a 15.7% reduction.

In carvedilol-treated patients, LV mass index was reduced by 12.8 ±3.5 g/m², representing a 9.0 % regression. Telmisartan was significantly superior to carvedilol, P <.0001.

In addition, the use of magnetic resonance imaging to assess LVH regression yielded similar results: a 15.0% regression with telmisartan versus a 9.8% regression for carvedilol, P <.0001.

Overall, the results demonstrate that while telmisartan and carvedilol provide comparable antihypertensive efficacy, telmisartan is associated with significantly greater LVH regression, Dr. Galzerano said.

Left ventricular hypertrophy is a strong predictor of cardiovascular risk, especially in hypertensive patients, and LVH regression is a key objective when managing hypertension.


[Presentation title: Multicentre Randomized Study on the Effect of Telmisartan Compared to Carvedilol on LV Mass: Three Dimensional Echocardiographic and Magnetic Resonance Assessment.]

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