Comparison of telmisartan versus losartan: meta-analysis of titration-to-response studies

Blood Press Monit. 2003 Jun;8(3):111-7. doi: 10.1097/00126097-200306000-00004.


Objectives: To compare the ability of telmisartan and losartan to reduce mean diastolic blood pressure (DBP) during the last 6 h of the 24-h dosing interval in a prospectively planned meta-analysis of ambulatory blood pressure monitoring (ABPM) data from two independent studies.

Methods: Data were from two independent randomized, double-blind, double-dummy, titration-to-response studies conducted in patients with mild-to-moderate hypertension (seated cuff DBP 95-109 mmHg, 24-h mean ambulatory DBP >or=85 mmHg). After a 4-week placebo run-in period, patients received once-daily telmisartan 40 mg or losartan 50 mg, with up-titration after 4 weeks to telmisartan 80 mg or losartan 100 mg, respectively, if seated trough cuff DBP >or=90 mmHg. Blood pressures were recorded using ABPM immediately before randomization and after 8 weeks of active treatment. In addition, seated trough cuff blood pressures were measured at baseline and after 4 and 8 weeks of active treatment.

Results: Titration to the higher dose was required in 60.1% of telmisartan patients and 69.5% of losartan patients (P=0.01). Reductions from baseline in the last 6 h mean ambulatory DBP with telmisartan and losartan were 6.6+/-0.4 and 5.1+/-0.4 mmHg, respectively (P<0.01, adjusted for baseline and study); the effects were homogeneous across the two studies. During the last 6 h of the 24-h dosing interval, telmisartan produced greater reductions in each of the observed hourly mean ambulatory DBP values. Telmisartan-induced reductions were also greater for the majority of the observed hourly mean ambulatory DBP values over the entire 24-h dosing interval. Reductions from baseline in the last 6 h adjusted mean ambulatory systolic blood pressure (SBP) for telmisartan and losartan were 9.9+/-0.6 and 7.8+/-0.6 mmHg, respectively (P=0.01). The 24-h profiles of ambulatory SBP hourly mean reductions were similar to those for DBP. Both telmisartan and losartan were found to be safe and well tolerated.

Conclusions: Telmisartan 40/80 mg is superior to losartan 50/100 mg in controlling DBP and SBP during the last 6 h of the 24-h dosing interval.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / pharmacology
  • Benzimidazoles / administration & dosage*
  • Benzimidazoles / pharmacology
  • Benzoates / administration & dosage*
  • Benzoates / pharmacology
  • Blood Pressure / drug effects*
  • Blood Pressure Monitoring, Ambulatory
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Losartan / administration & dosage*
  • Losartan / pharmacology
  • Male
  • Middle Aged
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Telmisartan
  • Titrimetry


  • Antihypertensive Agents
  • Benzimidazoles
  • Benzoates
  • Losartan
  • Telmisartan