Moderate
Acetylsalicylic acid × telmisartan
Antiplatelet agents (low dose) / NSAIDs (analgesic dose)×Angiotensin II receptor blocker (ARB)
Mechanism
High aspirin doses (above 1 g/day) may reduce the ARB's antihypertensive effect via vasodilator prostaglandin suppression. Cardioprotective doses (75–100 mg) are clinically minor.
Symptoms
Gradual blood pressure rise at high aspirin doses. At cardioprotective doses, no significant changes.
Management
Cardioprotective aspirin doses (75–100 mg) are acceptable without adjustment. At high doses, monitor blood pressure and increase telmisartan if needed. Alternative analgesic: paracetamol.