24-hour powerful blood pressure-lowering: is there a clinical need?

The early morning BP surge, which coincides with the peak incidences of stroke and myocardial infarction. BP, blood pressure.

Changes in SBP control in the 24 hours after a missed dose of telmisartan 80 mg or valsartan 160 mg in patients with mild-to-moderate hypertension (the MICADO I and II studies). SBP, systolic blood pressure. Reproduced with permission from Lacourciere Y, Krzesinski JM, White WB, Davidai G, Schumacher H. Sustained antihypertensive activity of telmisartan compared with valsartan. Blood Press Monit 2004;9:203–10.³²

Changes in 24-hour, daytime, nighttime, and morning SBP following treatment with telmisartan plus HCTZ or amlodipine plus HCTZ (the ATHOS [A comparison of Telmisartan plus HCTZ with amlodipine plus HCTZ in Older patients with predominantly Systolic hypertension] Study). HCTZ, hydrochlorothiazide; SBP, systolic blood pressure. Reproduced with permission from Neldam S, Edwards C, ATHOS Study Group. Telmisartan plus HCTZ vs. amlodipine plus HCTZ in older patients with systolic hypertension: results from a large ambulatory blood pressure monitoring study. Am J Geriatr Cardiol 2006;15:151–60.³³

Chemical structures of the ARB. ARB, angiotensin receptor blockers.

Plasma half-lives of ARB. ARB, angiotensin receptor blockers.