Telmisartan – A Potent Antihypertensive With Proven Cardiorenal – Metabolic Beneficial Effects
Nirvana Sabanovic-Bajramovic1, Mirna Aleckovic-Halilovic2, Larisa Dizdarevic-Hudic3, Sevleta Avdic4, Ljiljana Kos5,6, Bojan Stanetic5,6, Ammar Brkic6, Bojan Pejovic7, Denaida Ovcina-Sabanovic9
1 Clinic for Heart, Blood Vessels and Rheumatism, Clinical Center University of Sarajevo, Sarajevo, Bosnia and
Herzegovina
2 Department for Nephrology, Dialysis and Renal Transplantation, Clinic for Internal Medicine, University Clinical
Centre Tuzla, Tuzla, Bosnia and Herzegovina
3 Department for Cardiology, Clinic for Internal Medicine, University Clinical Centre Tuzla, Tuzla, Bosnia and
Herzegovina
4 Bayer MIB, Tuzla, Bosnia and Herzegovina
5 Department of Cardiology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
6 Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
7 Intensive Care Unit, Clinic for Internal Medicine, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
8 Hospital “Serbia”, East Sarajevo, Bosnia and Herzegovina
9 Health Care Institution, Sarajevo, Bosnia and Herzegovina
Corresponding Author: Nirvana Sabanovic-Bajramovic MD, MSc Clinic for Heart, Blood Vessels and Rheuma-tism, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina; E-mail: nirvana_sabanovic@ yahoo.com; Phone: +387 61 361 231; ORCID ID: 0000-0003-3749-6073
Cite this article: Sabanovic-Bajramovic N, Aleckovic-Halilovic M, Dizdarevic-Hudic L, Avdic S, Kos Lj, Stanetic B, et al. Telmisartan – a Potent Antihypertensive with Proven Cardio-Renal-Metabolic Beneficial Effects. Sar Med J 2025; 2(1): Online ahead of print. 
10.70119/0028-25
Pages: – / Published online: 26 April 2025
Original submission: 10 August 2024; Revised submission: 18 December 2024; Accepted: 06 April 2025
Abstract
Due to an epidemic of risk factors, such as hypertension, and an increase in life expectancy, cardiovascular disease (CVD) has an overwhelming morbidity and mortality burden worldwide.
Various treatment options are available to disrupt pathophysiological processes along the cardio-vascular continuum by focusing on distinct regions of the renin-angiotensin-aldosterone system (RAAS). As a RAAS inhibition, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are recommended fi rst-line treatments for hypertension and CVD. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Furthermore, a number of studies have shown that RAAS blockade can lower cardiovascular risk in ways that go beyond what could be predicted from lowering blood pressure alone.
However, the ARBs are not all equally eff ective. Telmisartan is a long-lasting ARB that eff ectively controls BP over the full 24-hour period. In high cardiovascular risk patients, telmisartan redu-ces cardiovascular events in a manner comparable to that of the ACE inhibitor ramipril beyond lowering blood pressure alone, but with better tolerability.
Research points to possible benefi ts for adipose tissue activity, neurovascular function, and en-hancements in glucose and lipid metabolism. According to several studies, telmisartan has par-tial peroxisome proliferator-activated receptor gamma (PPARγ) agonist activity, which improves insulin resistance in diabetic patients by modifying adipokine levels.
The combination of telmisartan and indapamide as metabolically neutral diuretic has an additio-nal positive antihypertensive as well as cardioprotective eff ects.
In addition to reviewing current CVD management guidelines, this article will examine important clinical trial and clinical practice data that assess the role of telmisartan/indapamide in CVD.
Keywords: arterial hypertension, angiotensin II receptor blocker, telmisartan, cardiovascular risk.
