ACE and obesity due to melanocortin 4 receptor deficiency: ARBs are a good choice for hypertensive patients with the metabolic syndrome (associated obesity) and there are compelling indications for their use in postmyocardial infarction, left ventricular hypertrophy, chronic kidney disease, type 2 diabetes with microalbuminuria or albuminuria for ACE-intolerant patients and for the secondary prevention of stroke.5 The evidence for therapeutic equivalence of telmisartan versus ACE inhibitors resides in direct major comparison trials with ramipril and perindopril.