What is the effect of telmisartan on hypertension at a dose of 20 milligrams?

From the Guidelines

Telmisartan at a dose of 20 milligrams is an effective treatment for hypertension, with a recommended daily frequency of once daily, as stated in the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1. The medication is typically taken once daily, usually in the morning, with or without food.

• The full effect of telmisartan on blood pressure may take up to 4 weeks to develop, as with other angiotensin II receptor blockers (ARBs) 1.
• It's essential to continue taking the medication even if you feel well, as hypertension is often asymptomatic. Telmisartan works by blocking the action of angiotensin II, a hormone that causes blood vessels to narrow.
• By preventing this narrowing, telmisartan allows blood vessels to relax and widen, thereby lowering blood pressure. While 20mg is an effective starting dose for many patients, your doctor may adjust the dose based on your individual response, with a range of 20-80 mg/day as recommended in the guideline 1.
• Regular blood pressure monitoring is essential to ensure the medication is working effectively. If you experience any side effects such as dizziness or low blood pressure symptoms, contact your healthcare provider promptly.
• It's also important to note that telmisartan can be used in combination with other antihypertensive agents, but caution should be exercised when combining with other medications that may increase the risk of hyperkalemia or other adverse effects 1.

From the FDA Drug Label

The magnitude of blood pressure reduction from baseline after placebo subtraction was approximately (SBP/DBP) 6-8/6 mmHg for 20 mg

• The effect of telmisartan on hypertension at a dose of 20 milligrams is a reduction in blood pressure of approximately 6-8/6 mmHg.
• This reduction in blood pressure occurs after the first dose, with a maximal reduction by about 4 weeks.
• The antihypertensive effect of telmisartan is maintained for the full 24-hour dose interval at a dose of 20 mg 2

From the Research

Effect of Telmisartan on Hypertension

• Telmisartan is an angiotensin II receptor antagonist that is highly selective for type 1 angiotensin II receptors 3.
• At a dose of 20 milligrams, telmisartan has been shown to be effective in reducing blood pressure in patients with mild to moderate hypertension, with mean reductions in supine trough systolic blood pressure and diastolic blood pressure of up to 15.5 and 10.5 mm Hg, respectively 3.
• In a study of patients with isolated systolic hypertension, telmisartan 20 mg once daily was found to be significantly superior to placebo in reducing systolic blood pressure, with a mean reduction of 15.6 mmHg 4.

Comparison to Other Antihypertensive Agents

• Telmisartan 20-160 mg/day was found to be generally similar in efficacy to enalapril 5-20 mg/day or lisinopril 10-40 mg/day in both titration-to-response and other studies 3.
• Telmisartan 40-120 mg/day was as effective as amlodipine 5-10 mg/day or atenolol 50-100 mg/day in dose-titration studies 3.
• In a study comparing telmisartan to hydrochlorothiazide, telmisartan 20 mg was found to be clinically comparable to hydrochlorothiazide 12.5 mg in reducing systolic blood pressure in patients with isolated systolic hypertension 4.

Tolerability and Safety

• Telmisartan was well tolerated in patients with mild to moderate hypertension and was significantly less likely to cause persistent, dry cough than lisinopril 3.
• In a study of patients with isolated systolic hypertension, all-causality adverse events occurred in 19.9% of patients receiving telmisartan 20 mg, which was similar to the incidence of adverse events in the placebo group 4.