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UPDATE 2-Blood pressure drug Micardis cuts heart risk-study

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CHICAGO, March 31 (Reuters) - The blood pressure drug Micardis was as effective in preventing serious heart problems in high-risk patients as certain older drugs, but with fewer side effects, international researchers said on Monday.

They found the Boehringer Ingelheim drug Micardis, or telmisartan, worked as well as the ACE inhibitor ramipril, marketed in the United States as Altace by King Pharmaceuticals Inc KG.N.

“We have one more alternative to use,” said Dr. Salim Yusuf of McMaster University in Ontario, Canada. “This is probably key for the 20 to 30 percent of people who don’t tolerate an ACE inhibitor,” said Yusuf, who presented the study at a meeting of the American College of Cardiology in Chicago.

Telmisartan is an angiotensin receptor blocker, or ARB. Ramipril is an angiotensin converting enzyme, or ACE, inhibitor. Both act on a compound called angiotensin in different ways to regulate blood pressure.

A team of international researchers compared the drugs in a a study of more than 25,620 patients with heart disease or diabetes and other heart risk factors, but not heart failure.

Telmisartan and ramipril alone worked equally well to reduce cardiovascular death, stroke, heart attack or hospitalization for heart failure, but telmisartan was easier to tolerate than ramipril, with fewer patients experiencing cough or other side effects.

“This is a high-risk trial to test against such a good compound,” Andreas Barner, a board member of Boehringer responsible for research and development, told Reuters.

“If you look a the tolerability, it is demonstrating that Micardis has become the new gold standard. That’s how we see it.”

Micardis is the first ARB to be shown to have heart benefits in patients who do not have heart disease. But since the drug is more costly than the typical ACE inhibitor, the study may not change practice, doctors said.

“The newer drug is certainly not better,” said Dr. Steven Nissen, a cardiologist from the Cleveland Clinic.

“The drugs were equivalent in the trial, which means that the same results can be achieved with an ACE inhibitor,” Nissen said in an interview. “I think most physicians will choose the drugs that are generically available,” he said.

The study, published online in the New England Journal of Medicine, also tested to see if Micardis combined with an ACE inhibitor might work even better. But the researchers found the combination caused a number of negative side-effects in patients who do not have heart failure.

Yusuf said the findings mean doctors need to be careful not not to use both drugs in patients. “What was even more important was adding the two together could cause harm,” he said. (Additional reporting by Mantik Kusjanto in Frankfurt; Frank Siebelt, writing by Mantik Kusjanto; Editing by Gary Hill/Andre Grenon)