Telmisartan fails to limit growth of abdominal aortic aneurysms

Telmisartan, a common antihypertensive medication, does not limit the growth of abdominal aortic aneurysms (AAAs), according to new findings published in JAMA Cardiology.

Prior studies have explored the effect of angiotensin converting enzyme (ACE) inhibitors on AAAs, finding that they did not make an impact. The researchers behind this study, however, believe they are the first to conduct a randomized clinical trial focused on treating AAAs with an angiotensin receptor blocker (ARB).

The authors tracked data from 210 study participants from Australia, the Netherlands and the United States who received either telmisartan or an identical placebo. The mean patient age was 73.5 years old. All patients had a small AAA visible on CT or ultrasound imaging findings, and none of them was already prescribed an ACE inhibitor or ARB. Patients were recruited from September 2011 to October 2016, and the final follow-up occurred in 2019.

Overall, patients in the telmisartan group had improved blood pressure levels—which is expected with an antihypertensive medication—but there was no statistical difference in AAA growth between the two groups.

The authors did add that their clinical trial only reached 70% of its planned enrollment, and some patients missed at least one scheduled follow-up imaging appointment. Also, “very few” participants underwent open AAA repair, so it is unclear how telmisartan treatment affected the aortic wall.

“The findings of this underpowered trial showed no effect of telmisartan in slowing AAA growth,” lead author Jonathan Golledge, MChir, of James Cook University in Australia, and colleagues concluded.

The group’s full analysis is available from JAMA Cardiology here.