title: Telmisartan: just an antihypertensive agent? A literature review.
abstract: BACKGROUND
  The modulation of the renin angiotensin aldosterone system (RAAS) is an important pathway in managing high blood pressure, and its overexpression plays a key role in target end-organ damage. Telmisartan is an angiotensin II receptor blocker (ARB) with unique pharmacologic properties, including the longest half-life among all ARBs; this leads to a significant and 24-h sustained reduction of blood pressure. Telmisartan has well-known antihypertensive properties, but there is also strong clinical evidence that it reduces left ventricular hypertrophy, arterial stiffness and the recurrence of atrial fibrillation, and confers renoprotection.
  
  
  METHODS
  This paper reviews telmisartan's pharmacological properties in terms of efficacy for hypertension control and, importantly, focuses on its new therapeutic indications and their clinical implications.
  
  
  CONCLUSIONS
  ONTARGET (ongoing telmisartan alone and in combination with ramipril global endpoint trial) demonstrated, that telmisartan confers cardiovascular protective effects similar to those of ramipril, but with a better tolerability. Moreover, recent investigations focused on the capability of telmisartan to modulate the peroxisome proliferator-activated receptor-gamma (PPAR-γ), an established target in the treatment of insulin resistance, diabetes and metabolic syndrome, whose activation is also correlated to anti-inflammatory and, finally, anti-atherosclerotic properties. Telmisartan shows peculiar features that go beyond blood pressure control. It presents promising and unique protective properties against target end-organ damage, potentially able to open a scenario of new therapeutic approaches to cardiovascular disease.
authors.affiliation: General Medicine Unit, Treviglio-Caravaggio Hospital, Medical Department, A.O. Treviglio, 24047 Treviglio (BG), Italy. Maurizio_destro@ospedale.treviglio.bg.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Destro
authors.forename: Francesca
authors.initials: F
authors.lastname: Cagnoni
authors.forename: Giuseppina Patrizia
authors.initials: GP
authors.lastname: Dognini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Galimberti
authors.forename: Carlo
authors.initials: C
authors.lastname: Taietti
authors.forename: Chiara
authors.initials: C
authors.lastname: Cavalleri
authors.forename: Emilio
authors.initials: E
authors.lastname: Galli
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D000959:Antihypertensive Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control; D001562:Benzimidazoles / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D001565:Benzoates / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics / Q000378:metabolism; D017379:Hypertrophy, Left Ventricular / Q000517:prevention & control; D007674:Kidney Diseases / Q000517:prevention & control; D012084:Renin-Angiotensin System; D000077333:Telmisartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D000077333:Telmisartan