Transcend aftermath: Angiotensin ii type 1 receptor antagonists (angiotensin receptor blockers) at the clinical crossroad

The present article synthetically revisits the recent results of TRANSCEND, putting them in the context of other clinical trials conducted with ACE inhibitors or angiotensin II type 1 receptor antagonists (angiotensin receptor blockers ARBs) compared with placebo. Based on these premises, the article provides an original meta-analysis on the effects of ACE inhibitors and ARBs on stroke and on combined cardiovascular (e.g. 'HOPE endpoint') outcomes in high-risk patients. In summary, the results of this analysis provide evidence that both ACE inhibitors and ARBs effectively and significantly reduce the incidence of cardiovascular outcomes compared with best available standard treatment (placebo) in high-risk patients. In view of the fact that the results of TRANSCEND were obtained in ACE inhibitor-intolerant patients, antihypertensive therapy based on telmisartan can be regarded as a new therapeutic option for treating patients at high cardiovascular risk. © 2009 Adis Data Information BV.