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Slide1:

Hypertension and Cardiovascular disease – raised expectations from recent outcome trials.

Slide2:

2 Prevalence of Hypertension, countries from our region Saudi Med J. 2007 Jan;28(1):77-84, Saudi J Kidney Dis Transpl 1999;10:376-81, Journal of Human Hypertension (2005) 19, 861–868. doi:10.1038/sj.jhh.1001909;   Saudi J Kidney Dis Transpl (0) 10: 357-64 KSA UAE EGYPT LEBANON KUWAIT JORDAN 26.1 % 36.6 % 26.3 % 23.1 % 26.3 % 16.3 % KSA 26.1%

Properties of the ideal antihypertensive:

Properties of the ideal antihypertensive The ideal antihypertensive should be CV protective - reduce cardiovascular morbidity and mortality Provide powerful and long lasting 24h BP reductions be safe and well tolerated Mustone-Alexander. Drugs 2006;66:1239–1252

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MICARDIS 80 mg: Superior to Amlodipine Lacourcière et al. Blood Press Monit 1998;3:295–302 * P=0.05 vs Amlodipine † Last 4 h of the dosing interval Powerful BP reduction in the early morning hours† *

Slide21:

21 Organ Protection

MICARDIS in type 2 diabetic nephropathy Improves renal endothelial dysfunction (TRENDY):

MICARDIS in type 2 diabetic nephropathy Improves renal endothelial dysfunction (TRENDY) * *** * P<0.05 vs baseline ***P<0.001 vs baseline Schmieder R.E., et al . J Hypertens 2005;23( Suppl 2):S147; Schmieder R.E., et al . Diabetes Care 2007; Mar 2 [ epub ahead of print ] % change vs baseline in RPF response to L-NMMA 0 10 20 30 40 50 60 70 Ramipril Telmisartan

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25 2 Losartan 4 6 8 10 12 14 16 Eprosartan Irbesartan Valsartan Candesartan MICARDIS Fold activation Olmesartan 5 micromolar S.C. Benson et al., Hypertension, 43:993-1002, 2004 Effects of low dose ARBs on PPAR  activity MICARDIS increases the activity of PPAR - a known target for anti-diabetic drugs

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ONTARGET Patients covered a broad range of high CV risk patients typically seen in General practice Coronary artery disease 19,102 Hypertension 17,607 MI 12,549 Diabetes 9,612 Stroke/TIA 5,342 * The ONTARGET Investigators. N Engl J Med 2008;358:1547–1559 The Strongest evidence with MICARDIS

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Safety & Compliance

Micardis Placebo like tolerability Fewer AEs than placebo in meta-analysis of 30 studies:

Micardis Placebo like tolerability Fewer AEs than placebo in meta-analysis of 30 studies % AEs / PY H Schumacher and G Mancia . Blood Pressure 2008;17(Suppl1):32-40 Placebo MICARDIS MICARDIS PLUS

Thank You :

Thank You 32

Slide33:

Thank you Mohamed Moukhtar

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