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September 6, 2024CureusOpen Access

Single-pill amlodipine, telmisartan, and chlorthalidone reduces blood pressure and improves control rates versus control treatments.

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Why the study?

Low-dose combination therapy is a promising approach for managing hypertension, but the safety and efficacy of a single-pill triple combination of amlodipine, telmisartan, and chlorthalidone required systematic evaluation.

Does a single-pill combination of amlodipine, telmisartan, and chlorthalidone improve blood pressure control in patients with essential hypertension?

Comparison

Single-pill amlodipine, telmisartan, and chlorthalidone vs usual care, amlodipine 10 mg, or telmisartan/amlodipine dual therapy

Design

Systematic review of randomized controlled trials

Key result

A single-pill combination of amlodipine, telmisartan, and chlorthalidone significantly reduced systolic and diastolic blood pressure and improved control rates compared to control treatments.

Authors

SEShereef ElbardisyMAMuteb N AlotaibiASAbdulbadih R Saad

Discussion

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Overview

Supports this triple single-pill combination for essential hypertension; confirms efficacy of low-dose triple therapy over dual regimens.

Study Design

Type

Systematic Review (n=1,124)

Structured PICO

Does a single-pill combination of amlodipine, telmisartan, and chlorthalidone improve blood pressure control in patients with essential hypertension?

P
Population
1,124 patients with essential hypertension pooled from 3 RCTs conducted in Sri Lanka and Korea. Mean age ranged from 56 to 62 years, 21.8% to 64% female, and 24% to 29% with diabetes.
I
Intervention
Single-pill, low-dose combination of amlodipine (2.5 to 5 mg), telmisartan (20 to 80 mg), and chlorthalidone (4.167 to 25 mg) administered for 8 weeks to 6 months.
C
Comparator
Control groups varied across the 3 included RCTs, consisting of usual care, high-dose amlodipine (10 mg), or dual therapy of telmisartan (40-80 mg) and amlodipine (2.5-5 mg).
O
Outcome
Mean change in sitting systolic blood pressure (BP)surrogate

A low-dose, single-pill triple combination of amlodipine, telmisartan, and chlorthalidone safely and effectively improves blood pressure control in patients with essential hypertension compared to usual care or dual therapy.

Limitations

  • Small sample size due to the low number of trials meeting eligibility criteria
  • Heterogeneity in control treatments, time points, and triple therapy doses
  • small sample size due to the low number of trials meeting eligibility criteria
  • heterogeneity in control treatments
  • heterogeneity in time points
  • heterogeneity in triple therapy doses

Cite This Study

Elbardisy et al. (2024) conducted a systematic review in Essential hypertension (n=1,124). Single-pill combination of amlodipine, telmisartan, and chlorthalidone vs. Usual care, amlodipine 10 mg, or dual therapy of telmisartan and amlodipine was evaluated on Mean change in sitting systolic blood pressure. A single-pill combination of amlodipine, telmisartan, and chlorthalidone significantly reduced systolic and diastolic blood pressure and improved control rates compared to control treatments.

synapsesocial.com/papers/6a129c73ea48cb855a352cdfhttps://doi.org/10.7759/cureus.68802
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