From the Research
Telmisartan is the angiotensin receptor blocker (ARB) with the longest half-life, approximately 24 hours, as demonstrated in studies such as 1 and 2. This extended duration of action allows for once-daily dosing and provides consistent 24-hour blood pressure control. Telmisartan is typically prescribed at doses ranging from 20-80 mg once daily, with 40 mg being the standard starting dose for hypertension. The long half-life of telmisartan is particularly beneficial for patients who occasionally miss doses, as it maintains therapeutic blood pressure control even when a dose is delayed. Some key points to consider when prescribing telmisartan include:
- Its high lipophilicity and strong binding affinity to the angiotensin II type 1 receptor, which contribute to its extended duration of action, as noted in 3 and 4.
- Its unique property of activating PPAR-gamma receptors, which may provide metabolic benefits beyond blood pressure control, as discussed in 5 and 1.
- The results of the ONTARGET trial, which showed that telmisartan is as effective as ramipril in reducing cardiovascular morbidity and mortality in a broad range of patients at increased cardiovascular risk, as reported in 1 and 2. When switching from another ARB to telmisartan, no special titration is typically needed, and the transition can usually be made directly to an equivalent dose. Overall, telmisartan's pharmacological properties and clinical benefits make it a valuable treatment option for patients with hypertension and those at risk of cardiovascular disease, as supported by studies such as 3, 5, 1, 4, and 2.