CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 1, January/February 2010
62
AFRICA
of the ARBs, losartan and valsartan, the
calcium-channel blocker, amlodipine, and
the ACE inhibitor, ramipril. This agent is
particularly effective during the last six
hoursofthedosingintervalwhenotheranti-
hypertensives tend to have reduced effec-
tiveness. Telmisartan is, therefore, a highly
appropriate antihypertensive for sustained
24-hour blood pressure control, especially
during the risky early morning hours.
Mosendane T, Mosendane T, Raal FJ. Shift
1.
work and its effects on the cardiovascu-
lar system.
Cardiovasc J Afr
2008;
19
(4):
210–215.
Marler JR, PriceTR, Clark GL,
2.
et al
. Morning
increase in onset of ischemic stroke.
Stroke
1989;
20
: 473–476.
Muller JE, Stone PH,Turi ZG,
3.
et al
. Circadian
variation in the frequency of onset of acute
myocardial infarction.
N Engl J Med
1985;
313
: 1315–1322.
Rocco MB, Barry J, Campbell S,
4.
et al
.
Circadian variation of transient myocardial
ischaemia in patients with coronary artery
disease.
Circulation
1987;
75
(2): 395–400.
Kario K, Pickering TG, Umeda Y, Hoshide
5.
S,
et al
. Morning surge in blood pres-
sure as a predictor of silent and clinical
Cerebrovascular disease in elderly hyperten-
sives: a prospective study.
Circulation
2003;
107
: 1401–1406.
Redon J, Roca-Cusachs A, Mora-Macia.
6.
Uncontrolled early morning blood pressure
in medicated patients: the ACAMPA study.
Analysis of the control of blood pressure
using ambulatory blood pressure monitoring.
Blood Press Monit
2002;
7
: 111–116.
McInnes G. 24-hour powerful blood pressure
7.
lowering: is there a clinical need?
Am Soc
Hypertens
2008;
2
(4): S16–S22.
Parati G, Schumacher H, Mancia G.
8.
Evaluating 24-hour antihypertensive efficacy
by the smoothness index: a meta-analysis of
an ambulatory blood pressure monitoring
database
J Hypertens
2006;
24
(4): S301.
White WB, LacourciereY, Davidai G. Effects
9.
of the angiotensin II receptor blockers
telmisartan versus valsartan on the circadian
variation of blood pressure.
Am J Hypertens
2004;
17
: 347–353.
Williams B, Gosse P, Lowe L, Harper R,
10.
PRISMA I study group. The prospective,
randomized investigation of the safety and
efficacy of telmisartan versus ramipril
using ambulatory blood pressure monitor-
ing (PRISMA I).
J Hypertens
2006;
24
:
193–200.
Lacourciere Y, Neutel JM, Davidai. A multi-
11.
centre, 14-week study of telmisartan and
ramipril in patients with mild-to-moderate
hypertension using ambulatory blood pres-
sure monitoring.
Am J Hypertens
2006;
19
:
104–112.
Dr Charles Kiiza Mondo, PhD
Consultant physician (cardiology), Head of Echocardiography,
Research and Fellowship Training
Tel: 256-772-462370/256-41-541589
e-mail:
