Okay, okay! I won’t switch from telmisartan. 
Haha it’s okay. I just didn’t want people reading us to believe that ACEI/ramipril was significantly better than ARB/telmisartan for stroke prevention as current evidence doesn’t show this. Of course, future studies might change the conclusion. But as of today, the best first line anti hypertensive seems to be a combination [telmisartan + (amlodipine and/or indapamide)].
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Just to be clear, is there an intrinsic reason why telmisartan + amlodipine and/or indapamide are superior to higher-dose telmisartan, or is it simply the aversion of possible side effects that come from higher-dose telmisartan? In other words, if a patient is effectively controlling hypertension with 80 mg telmisartan without side effects, is it nonetheless beneficial to switch to lower-dose telmisartan + amlodipine and/or indapamide?
I mentioned the two-drug combination for therapy initiation only. Here’s the rationale: Optimal Blood Pressure we Should Target? Systolic Under 110 or 100? - #244 by adssx
If someone is already on telmisartan 80 mg monotherapy and well-controlled: If it ain’t broke, don’t fix it? 
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Preprint but great team: Association between Class of Antihypertensive Drugs and Risk of Incident Dementia: A Multinational Population-Based Cohort Study 2024
1,982,839 individuals followed over more than 6 years in 4 countries (UK, HK, Sweden, and Australia):
Our study supports the use of ARBs compared to ACEI when considering the risk of cognitive decline and dementia, based on a multi-ethnic cohort with a long median follow-up time.
Unfortunately, they didn’t do the job properly and didn’t distinguish DHP CCBs (e.g., amlodipine, associated in many studies with lower rate of dementia) from non-DHP CCBs and thiazide/thiazide-like diuretics (e.g., indapamide) from other diuretics (e.g., loop diuretics).
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