BACKGROUND: Cardiovascular disease (CVD) places a significant burden on 
healthcare providers. High blood pressure (BP) is the single most prevalent risk 
factor for CVD worldwide and is responsible for more deaths than any other risk 
factor. 'Cardiovascular (CV) high-risk patients' make up the broad cross-section 
of patients in the middle of the risk spectrum for CVD progression that is 
referred to as the CV continuum and includes those with atherothrombotic 
disease, those with target organ damage associated with type 2 diabetes and 
those with multiple risk factors. Angiotensin II is involved in CVD progression 
at every stage of the CV continuum, making the renin-angiotensin system a 
rational target for pharmacologic intervention. Angiotensin II receptor blockers 
(ARBs) offer a better tolerated alternative to angiotensin converting enzyme 
inhibitors, with greater long-term adherence. The ARB telmisartan recently 
received an indication for CV prevention.
SCOPE: A PubMed literature search was conducted to identify evidence on the use 
of telmisartan for preventing CV events.
FINDINGS: Telmisartan has a favourable safety and tolerability profile, and has 
demonstrated efficacious and long-lasting 24-hour BP reductions, whether as 
monotherapy or in combination with hydrochlorothiazide or amlodipine. In the 
largest CV prevention trial program undertaken with an ARB (the ONgoing 
Telmisartan Alone and in combination with Ramipril Global Endpoint Trial; 
ONTARGET), telmisartan 80 mg/day alone was as effective as ramipril in reducing 
the composite primary endpoint of CV mortality, non-fatal myocardial infarction, 
non-fatal stroke and hospitalization for heart failure in CV high-risk patients. 
However, patients were significantly more likely to adhere to treatment with 
telmisartan than ramipril due to its better tolerability.
CONCLUSION: To date, telmisartan is the only ARB indicated to reduce CV 
morbidity in a broad CV high-risk population.