From the FDA Drug Label
The primary 4-component composite endpoint was death from cardiovascular causes, myocardial infarction, stroke, and hospitalization for heart failure.
Table 2: Incidence of the Primary and Secondary Outcomes from TRANSCEND *Composite of CV death, myocardial infarction, stroke, or hospitalization for heart failure465 (15.7%) / 504 (17.0%)0.92 (0.81 – 1.05)0.2129
Table 3: Incidence of the Primary and Secondary Outcomes from ONTARGET Composite of CV death, myocardial infarction, stroke, or hospitalization for heart failure1423 (16.7%) / 1412 (16.5%)1.01 (0.93 – 1.10)
Telmisartan for heart failure:
- The studies ONTARGET and TRANSCEND evaluated the effect of telmisartan on cardiovascular events, including hospitalization for heart failure.
- The results show that telmisartan is not significantly different from ramipril in reducing the risk of hospitalization for heart failure, and may be more effective than placebo in this setting.
- However, the combination of telmisartan and ramipril increased the incidence of renal dysfunction compared to either medication alone.
- Key points:
- Telmisartan may reduce the risk of cardiovascular events, including hospitalization for heart failure.
- Telmisartan is not significantly different from ramipril in reducing the risk of hospitalization for heart failure.
- The combination of telmisartan and ramipril should be used with caution due to the increased risk of renal dysfunction. 1
From the Research
Telmisartan for Heart Failure
- Telmisartan has been shown to be effective in reducing cardiovascular morbidity and mortality in patients with heart failure, as demonstrated in the ONTARGET trial 2.
- The TRANSCEND study found that telmisartan reduced cardiovascular events in high-risk patients, except for heart failure hospitalization, and can be considered as a first-line therapy in those intolerant to ACE inhibitors 3.
- Telmisartan has been found to have a promising role in reducing cardiovascular risk in high-risk patients, including those with heart failure, as highlighted in the article "Telmisartan and cardioprotection" 4.
Effects of Telmisartan on Mortality and Morbidity
- A study published in the Journal of the American College of Cardiology found that adding telmisartan to standard therapies with angiotensin-converting enzyme inhibitors significantly reduced all-cause mortality, cardiovascular death, and heart failure hospital stays in hemodialysis patients with chronic heart failure 5.
- The ONTARGET trial found that telmisartan was equivalent to ramipril in patients with vascular disease or high-risk diabetes, and was associated with less angioedema 6.
Telmisartan Compared to Other Treatments
- The TRANSCEND study compared telmisartan to placebo in patients with cardiovascular disease who were intolerant to ACE inhibitors, and found that telmisartan reduced cardiovascular events, except for heart failure hospitalization 3.
- The ONTARGET trial compared telmisartan to ramipril in patients with vascular disease or high-risk diabetes, and found that telmisartan was equivalent to ramipril in reducing cardiovascular events 2, 6.