Summary: In the ESC/ESH 2018, five major drug classes are recommend-ed for the treatment of hypertension: ACE inhibitors, ARBs, beta blockers, CCBs and diuretics ‒ thiazides and thiazide-like diuretics based on the proven ability to reduce BP, CV events and (equivalently) overall CV morbidity and mortality resulting from BP lowering.
ARBs are among the most widely used classes of antihypertensive drugs and are associated with significantly lower treatment discontinuation rates for adverse events than those all other antihypertensive therapies and similar rates to placebo. Among several beneficial effects of sartans on CV system, brain and kidney, ARBs reduce albuminuria more than other BP-lowering drugs, are effective at delaying the progression of diabetic and non-diabetic CKD, prevent or regress HMOD and are indicated post-myocardial infarction and in patients with chronic HFrEF.
According to the ESC/ESH (2018) guidelines the treatment of hypertension should be preferentially based on combinations of the ARB or ACE inhibitor with the CCB and or a thiazide/thiazide-like diuretic, which are now widely available in a single pill and in the range of doses facilitating simplification of the doses.
The current review summarizes the current recommendations for ARDs in the treatment of hypertension with the specific goal to overview the efficacy and tolerability of telmisartan in the treatment of stage 2 and stage 3 hypertension, also in combination with hydrochlorothiazide 12.5 mg for the management of patients with hypertension.