A Clinical Trial for People HIV+ Age > 50 at Risk for Heart Disease

Inclusion Criteria:

- HIV positive men and women > 50 years of age.

- HIV-1 RNA documented to be < 50 copies/mL at screening and undetectable by assay of
choice (< 50 or < 400 copies/mL) for at least 12 weeks prior to entry.

- Current ART with a suppressive, highly active regimen. Subjects must not have changed
ART in the 12 weeks prior to entry, and must not be planning to change ART for the
12-week study duration.

- Systolic blood pressure > 110mmHg.

- One or more risk factors for CVD (smoking, hypertension, hyperlipidemia, diabetes
mellitus). Note: family history of early heart disease alone will not be a sufficient
entry criterion.

- Ability and willingness of subject to provide informed consent.

Exclusion Criteria:

- Pregnancy (current or within the past 6 months) or nursing.

- Uncontrolled hypertension:

- Prohibited concomitant medications: Other members of the angiotensin
receptor-blocking class (losartan, irbesartan, olmesartan, valsartan, candesartan;
wash-out period allowed), nelfinavir, and etravirine. Subjects taking nelfinavir or
etravirine will be excluded due to the possibility of increased drug levels via
inhibition of cytochrome P-450 2C19.

Note 1: Subjects requiring amifostine or rituximab must be aware of the increased risk of
orthostatic hypotension with the addition of telmisartan. Any subject requiring lithium
therapy while on study must have lithium levels monitored closely by their outside
physician. All subjects on the above listed medications should provide documentation that
their physician is aware of the study protocol.

Note 2: Subjects taking thiazolidinediones must be on stable dosing (> 12 weeks) and must
agree to refrain from dose titration for the 12-week study duration.

- Untreated hyperlipidemia: Subjects must be willing to abstain from initiating therapy
for the 12-week study duration. Subjects on a stable (> 12 weeks) lipid-lowering
regimen must be willing to remain on their current dose for the 12-week study
duration.

- Subjects undergoing treatment for diabetes with oral hypoglycemic agents must be
willing to remain on their current dose of insulin-sensitizing agents
(metformin/biguanides) for the 12-week study duration. Titration of other diabetes
(except thiazolidinediones, see 4.2.3) medications will be permitted.

- Screening laboratory values as follows:

- ANC < 750 cells/mm3

- Hemoglobin < 10 gm/dL

- Creatinine clearance < 30 mL/min (estimated by Cockcroft-Gault equation using ideal
body weight)

- AST or ALT > 3 times ULN

- Known, untreated, renal artery stenosis.

- Unstable coronary artery disease/angina, decompensated congestive heart failure, or
predicted need for cardiovascular surgery within the study period.

- History of intolerance to any member of the angiotensin receptor blocker class of
agents.

- Need for ongoing potassium supplementation.

- Active, untreated opportunistic and/or AIDS-defining illnesses.