The role of the renin-angiotensin system (RAS) in hypertension is well documented. Blockade of the system with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB) lowers blood pressure and the risk of cardiovascular disease (CVD).

Telmisartan is an ARB that shows high affinity for the angiotensin II type 1 (AT1) receptor, has a long duration of action, and has the longest half-life of any ARB. In addition to blocking the RAS, telmisartan acts as a selective modulator of peroxisome proliferator-activated receptor-gamma (PPAR-γ), a central regulator of insulin and glucose metabolism. It is believed that telmisartan?s dual mode of action may provide protective benefits against the vascular and renal damage caused by diabetes and CVD.

The progression of cardiovascular and renal disease follows a continuum, with each step representing a later stage of disease and hence, greater treatment challenges. The cardiovascular disease continuum is illustrated in blue below, and the renal continuum is illustrated in red. The PROTECTION^® trials were carried out in a wide range of patients with different stages of disease in order to test the efficacy of telmisartan in both early and more advanced disease.