Telmisartan and valsartan present lower risk of heart attack and strokes in diabetes patients

Telmisartan and valsartan, used to reduce blood pressure in people with diabetes, are associated with a lower risk of hospitalization for heart attack, stroke, or heart failure, according to a study published in the Canadian Medical Association Journal.

The study, published on July 8, 2013, was led by Tony Antoniou, PharmD, Department of Family and Community Medicine at St. Michael’s Hospital in Toronto.

The researchers studied data for more than 54,000 Ontario residents with diabetes who were 65 and older and took angiotensin-receptor blockers between April 2001 and March 2010. They sought to determine if there was a lower risk of cardiovascular illnesses in people taking telmisartan compared with other drugs in the same class, since there is evidence from previous small trials that telmisartan has slightly different properties than other angiotensin-receptor blockers and may improve cardiovascular health.

They found that patients who took either telmisartan or valsartan had a lower risk of the composite outcome, compared with patients who took irbesartan.  “No significant difference in risk was seen between other angiotensin-receptor blockers and irbesartan. In secondary analyses, we found a reduced risk of admission to hospital for heart failure with telmisartan compared with irbesartan, but no significant differences in risk were seen between angiotensin-receptor blockers in our other secondary analyses,” Antoniou wrote.

The findings suggest that “statistically important differences exist in the effectiveness of angiotensin-receptor blockers when used for the prevention of diabetes-related macrovascular disease,” according to Antoniou. “A class effect for these agents may not be assumed when used for this purpose in clinical practice,” he wrote.

The authors suggest that randomized controlled trials and large observational studies looking at cardiovascular health and deaths in patients taking different angiotensin-receptor blockers are needed.