Do you remember when we talked last year about the purpose of preventive medicine?  Then you remember that the point of blood pressure medicine isn’t to lower blood pressure, it’s to prevent strokes and heart attacks.

There are now many blood pressure medicines that have been proven to prevent strokes and heart attacks and have track records of safety lasting decades.  These older medicines are also available generically and so are fairly inexpensive.  That’s a tough market to break into.

So new blood-pressure medications have to justify their higher price tags by proving that they have fewer side effects or are more effective than their older competitors.  Micardis (telmisartan) is a blood pressure medicine in a family called angiotensin receptor blockers (ARBs).  The novel mechanism of ARBs raised hopes that it would prevent strokes better than other blood pressure medicines.

A study published this week in the New England Journal of Medicine tested that hope.  Patients who had had a recent stroke were randomized to Micardis or placebo.  Other blood pressure medications were used as needed to control blood pressure.  The patients were followed to count the incidence of a second stroke.  The disappointing outcome was that the patients on Micardis had as many strokes as patients on other medications.

Just yesterday the pharmaceutical representative who gives our office samples of Micardis came by and told me how well Micardis is tolerated and how well it lowers blood pressure.  She didn’t mention that study at all.  I wonder why.

Learn More:

Washington Post article: Newer Blood Pressure Drug No Better Than Placebo in Preventing Stroke

New England Journal of Medicine article: Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events