High-risk Hypertension and Its Clinical Implications.

Hypertension (HT) is a well-established risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD). Only <50% of treated hypertensive patients have a BP of <140/90 mmHg, which is a cause for much concern. These treated but inadequately controlled hypertensive patients are at significant risk for developing CVD and other complications. Telmisartan is a long-acting angiotensin receptor blocker (ARB), which has multiple positive effects aside from its antihypertensive efficacy. It reduces CV events in high-risk patients, has favorable effects on endothelial function including renoprotective effects. Trials like the MAPHY and BCAP have shown that β blockers (metoprolol) have beneficial effects on outcomes and survival along with reduction in BP. Most hypertensives need combination approach to control their high BP. Being cardioprotective drugs, combination of telmisartan and metoprolol is beneficial for secondary prevention of cardiovascular events in high-risk patients with HT.