It looks like if you have atrial fibrillation vulnerability, 40mg telmisartan lowers BP, but doesn’t affect AF. In contrast 80mg telmisartan lowers both BP and AF:
Conclusion: The results indicated that telmisartan in low doses was as effective in controlling the blood pressure as in high doses, but high doses of telmisartan had beneficial effects on preventing the recurrence of AF in hypertensive patients.
It’s an Egyptian paper. However the results appear interesting.
The dose of Telmisartan is 80 mg. HBA1C is reduced by 1.5 (along with variability) which is quite significant!
I decided to start telmisartan and I had 40mg on Dec 8, then I missed the dose on Dec 9, and then I took 40mg each of the past 4 evenings (including tonight).
Early in the evening yesterday I noticed I felt pretty good. Then I felt really great all day today, and I noticed that I was talking to way more people (at the gym, in a store I went to, and even to a parking lot attendant). Whether I’m consistently initiating conversations with random strangers is probably my best marker for if I’m truly in a good mood.
Anyways, maybe it’s the telmisartan? I remember a couple people in this thread mentioned it positively affected their mood and reduced apathy.
I never started the Amlodipine because my BP has continued downward average and now averaging:
117/77
I know some see slightly lower as ideal but for me this is PHENOMENAL!
After nearly 2 decades 140/95 averages at the doctor with excuses like “it must just be white coat syndrome” sort of denial, along with “just drop some weight and salt and let’s check in in a few months”.
I dropped the weight (averaged 270 pounds for many years, highest was 329, sometimes crash dieted to 240s) with Tirzepatide and the final few pounds switching to Retatrutide (maintaining health BMI and BRI at 180 pounds, 9mg Reta/week). But even weight loss only dropped BP averages to mid-130s/upper-80s.
40mg daily Telmisartan (thanks @adssx !) and Reta 9mg/week (which has its own BP lowering impact) seems to have gotten me to distance!
Shocked and thankful. Not sure what I’ll do with the year supply of Amlodipine from India now but for less than $70 I’m happy for it to sit unused.
The telmisartan mood phenomenon is a bit difficult to describe, isn’t it, but your experiences are very much the same as mine. I like your observational metric. It formal tests, it might demonstrate good predictive and discriminant validity.
This is a brief report for those interested. A month ago, I increased my dose of telmisartan from 40 mg at bedtime to 80 mg at bedtime. I can detect no symptoms and my BP readings are the same as they were on 40 mg. For me, the initial dose led to a drop from high normal/borderline high to the current state of mid- to low normal, maybe an average drop of 15-18 points SBP and little drop in DBP because it was already mostly in the low normal range.
The most significant benefit I’m seeing in telmisartan is a significant reduction the standard deviation of the distribution of my readings. As one example, I no longer see those high morning spikes typical of pre-telmisartan. The worst case now is a reading of 122/70. I believe this reduction in variance could be more significant to reducing ASCVD events than merely lowering mean BP by 10-15 points.
Great thread so much in the trenches info, much appreciated!
BP had creeped up to 152/103 and scared the bezeebus out of me, so I went to the GP to specifically request Telmisartan. Never taken BP meds before.
At the appointment my BP was 142/93, and the PA said I didn’t have high blood pressure and didn’t need any medication. I told her she was wrong and I wanted to start on 40mg of Telmi, she said she needed an OK from the Dr. first as this was not what they normally do as they start with diuretics first… I said I’m not taking those or statins and request that you prescribe the Telmi… she came back 5’ later with the OK.
I took my first dose at 1pm, by 7pm my BP dropped 10 points, very pleased, had my lowest BP reading in many months.
Only 1 day, but there does seem to be a mood lift, I feel great today! Also, this stuff makes me lose a lot of water, peeing like a rhino today.
Hope I get more BP drop in the coming weeks. Thanks to all for posting your experiences.
I agree @RufusDawes. The sharing, collegiality, and depth of knowledge here are unparalleled. It pleased me when I read of your experience just now, and how people here may have provided needed information at the right time for you.
I’m sure you know that it takes quite a few BP readings, taken under different conditions common to you, and with some control over the external environment, to arrive at a good profile of your BP. Nonetheless, it is incomprehensible that your medical office was ready to blow off your significantly elevated reading without at least further investigation. It would seem they have not kept up with national guidelines for many years. Your elevated readings might have been so-called white coat hypertension (as has been my lifelong situation) or may reflect your typical blood in normal, relaxed environments. Either way, it is in your interest based on the best available evidence to move it down to at least the middle range of normal BP.
I found that the “relaxation” effect of telmisartan kicked in almost immediately but was so subtle that it took a few days to pinpoint it. As I recall, my BP also dropped close to 10 points early on but I found that it required 20-30 days for the lowering effect to fully stabilize with no further decreases. As is common, my readings are higher in the morning (typically ~122/72) and lowest in the evenings when a reading of 110/65 is not uncommon). I also think my “white coat” spikes, which in the past could be 150/90 or more are much more constrained now. My BP at my last flight physical, standing and talking with no rest, was 128/78.
The current reductions and changes in variance as as far as i’m interested in going. That’s as far as I’m interested in going. I now measure my BP for a day or two every few months and don;t think about it otherwise.
Good luck and keep everyone posted.
Update: the 40mg daily Telmisartan lowered my bp 20pts to 122/81, just what I was looking for. However, it gave me a weekly sinus infection or a chest cold, both mild, but one of the lesser side effects.
I went off it and now trying Amlodipine 5mg daily, so far so good. Like what was mentioned, takes 3-4 weeks to see the medication fully kick in, hoping for no unusual side effects (so far just mild headache in the morning that goes away, and a mild flushing in the face that also goes away).
I was looking to lower BP and started using 40mg then 80mg (for the PPAR activation). But I reduced to 40mg because I had transient low BP causing some light headedness.
My BP no longer measures above 133/85 (highest measure in last couple months) and usually is around 116/76. Likely had some additional improvement from 9mg Retatrutide weekly too. Stopped most supplements (beet root extract, magnesium, etc) related to BP.
Yes. I had a similar problem. It is too effective. I’ve reduced my dose from Telmisartan 40 mg to 20 mg and my arms no longer fall asleep at night while I sleep.
A new medication recently approved which is a PPAR delta agonist is called Seladelpar. Studies are limited for now to primary biliary cholangitis but I’d be interested to see if it had similar performance enhancement effects to cardarine.
Cardarine cancer effects were always so unfortunate to me, it seems like such a promising molecule otherwise.
I did find this with more information on PPAR delta agonists including but not limited to Seladelpar:
As I continue to explore drug combinations for my own possible future use, I post studies which I think might have general interest. And so I posted several interesting studies on the combination of telmisartan and pioglitazone in the pioglitazone thread, and I’m linking them here. There I also posted an extremely interesting study looking at the differential effects of telmisartan and pioglitazone on mTORC2 driven cell proliferation and migration.
As pioglitazone has been associated with increased risk of bladder cancer, taking it concurrently with telmisartan might be of interest.
Telmisartan inhibits human urological cancer cell growth through early apoptosis
Pioglitazone has been associated with increased risk of bone fractures. Telmisartan, being a partial PPAR-gamma agonist, might also be suspected to increase bone fracture risk. However as the mode of telmisartan activity differs significantly from pioglitazone, so there has been some interest in determining whether sartans such as telmisartan or losartan has any impact on the biology of bone health.
Effects of telmisartan and losartan treatments on bone turnover markers in patients with newly diagnosed stage I hypertension
“Neither telmisartan, despite its partial peroxisome proliferator-activated receptor-γ agonistic effect, nor losartan treatment had significant effects on bone turnover markers in newly diagnosed stage I hypertensive patients.”
Sage advice 
What’s the reasoning behind the PPAR agonist hype, is this mechanistic speculation? I might’ve missed it.
I’m not so sure it’s possible to predict outcomes solely on e.g PPAR agonism, AMPK activation, or mTOR inihibition.
Cardarine massively increased cardiovascular endurance, but it had cancer worries in trials and was abandoned before it was approved for human use. It seemed like a miracle drug and really want something like that without cancer issues to succeed.
You’re correct that it is hard to predict outcomes solely on isolated mechanisms. But if we can get something like cardarine without the risk that would be so damn good.
That’s very unlikely to happen because the more conditionals you add the less likely it becomes. It’s like a fractal once you zoom in you see more complexity that you need to research to even be sure of your previous conclusion.
If you ignore complexity for a moment and take it as given that the mechanism of action is that, it would automatically inherent the cancer causing issue as well. It’s not that simple so PPAR enjoyers don’t have to worry but I’m just saying.
If you really want to succeed in this area study mechanism with genetic support. That’s what you should spend your time on. Why? Those are natural randomized trials, which actually find outcomes, and genetic studies find the mechanisms for outcomes. If you think about it it makes sense.
Small multiple or single genetic changes in humans can cause or prevent disease, or change something else. It’s not selected by mate choice so it’s random, which fulfills the criteria of experimental studies (mendelian randomization they are called).
I actually looked into the cardiovascular endurance part but the human studies weren’t too convincing. I’ve taken it in the past but honestly, can’t remember if it helped my cardio fitness or not since it’s been so long. It seems to be the one major thing that really sets it apart from anything else is that it raises HDL, but does it even matter?
The cancer doses were very high but they didn’t test for it in lower doses in rats. Still, I am not convinced it’s a big concern, but I understand the hesitation regardless and admit it’s one of the reasons I haven’t used it again. Anecdotally, I used it a bunch and don’t have cancer.
Here is a AI response
Current human clinical studies on cardarine (GW501516), a PPARδ agonist, do not demonstrate improvement in cardiovascular fitness or exercise capacity in healthy individuals.
| Evidence Source | Study Population | Outcome on Cardiovascular Fitness | Clinical Evidence |
|---|---|---|---|
| GW501516 RCT | Healthy overweight men | No effect measured/reported | No improvement in fitness 1 |
| Metabolic studies | Healthy volunteers | Improved lipid profile only | No fitness change 3 |
| Animal studies | Rodents | Increased endurance | Not validated in humans 4 |
Conclusion:
There is no high-quality human evidence supporting the use of cardarine to improve cardiovascular fitness. Its use is not recommended due to lack of efficacy data for fitness and potential safety risks.
