Boehringer Ingelheim’s blood pressure drug Micardis outperformed other leading angiotensin II receptor blockers in a ‘smoothness index’ study reported at the European Society of Hypertension annual meeting, Madrid, Spain.

The study analysed pooled data from over 5,100 patients with mild to moderate hypertension in which 24-hour ambulatory blood pressure monitoring (ABPM) had been used to monitor the success of therapy.

In the crowded anti-hypertensive market, 24-hour ABPM is becoming an increasingly important tool for evaluating therapy. More than 200 presentations at ESH reported findings from ABPM studies.

According to the data presented on Micardis (telmisartan), the drug hits three key blood pressure goals: it reduces average 24-hour blood pressure; it reduces the excessive early morning surge in blood pressure which occurs on awakening and which has been linked to cardiovascular events; and it reduces excessive variability (peaks and troughs) in blood pressure during the course of the day.

The latter was evaluated using a new measure, the ‘smoothness index’ (SI), a mathematical tool which takes into account both the magnitude and the consistency of blood pressure reduction over a complete 24-hour dosing interval.

Professor Luis Ruilope of Madrid’s Hospital 12 de Octubre, who is chair of the ESH scientific and organising committee, said that many drugs effectively reduce blood pressure, but it was important to distinguish agents providing effective 24-hour control. “Micardis combines 24 hour control with placebo-like tolerability.”

The data provided at ESH provide a powerful endorsement for Micardis. According to the SI data, the drug provided more effective blood pressure control over 24 hours than other commonly used ARBs, including Novartis’ Diovan (valsartan) and Merck & Co’s Cozaar (losartan), as well as the ACE inhibitor ramipril, and was comparable to the calcium channel blocker amlodipine. However, it is more tolerable than amlodipine, says Boehringer Ingelheim.

The results presented will add to pressure for 24-hour ABPM to become a standard part of patient and drug assessment (as was recently recommended in France). “Office [clinic] blood pressure does not offer doctors or patients a fair indication of the long-term risks because hypertension is a 24 hour condition,” said Professor Philippe Gosse of the Hopital Saint Andre in Bordeaux.

Boehringer Ingelheim markets telmisartan in 84 countries around the world, including the USA, Japan and European countries. The drug is sold in cooperation with Astellas Pharma in Japan, Bayer HealthCare in Europe and GlaxoSmithKline in selected markets. Bayer HealthCare promotes telmisartan under the brand names Kinzalmono, Kinzalkomb (combination with HCTZ), and Pritor and PritorPlus in markets across Europe. Pritor and PritorPlus is also marketed by GlaxoSmithKline in selected markets.