Evaluation of Angiotensin II Receptor Blockers for 24‐Hour Blood Pressure Control: Meta‐Analysis of a Clinical Database

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Abstract
Angiotensin II receptor blockers are well tolerated and improve compliance in hypertensive patients. The need for 24‐hour blood pressure control has focused attention on whether all agents in this class maintain smooth antihypertensive effects over a 24‐hour period. Insight into this issue emerged from a meta‐analysis of five large, multicenter trials in which ambulatory blood pressure monitoring was used to compare the antihypertensive effects of three angiotensin II receptor blockers: telmisartan, losartan, and valsartan. These trials used either a double‐blind, placebo‐controlled or a prospective, randomized, open‐label, blinded‐end point design. Initial analysis established the validity of combining ambulatory blood pressure monitoring data from the double‐blind, placebo‐controlled and prospective, randomized, open‐label, blinded‐end point designs. Subsequent analyses revealed that telmisartan 80 mg was significantly more effective than losartan 50 mg and valsartan 80 mg for reducing 24‐hour mean blood pressure. Furthermore, telmisartan 80 mg was comparable to amlodipine 5 mg for controlling the early morning surge in blood pressure.

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