Key result
Telmisartan linked to target blood pressure achievement in ~45% of hypertensive patients at 8 weeks.
Why the study?
Does telmisartan (with or without hydrochlorothiazide) reduce blood pressure in primary care patients with essential hypertension not at target BP?
Observational (n=100)
Open-label
Yes
Does telmisartan (with or without hydrochlorothiazide) reduce blood pressure in primary care patients with essential hypertension not at target BP?
In a primary care setting, switching to or starting telmisartan (with or without hydrochlorothiazide) significantly improved office and 24-hour ambulatory blood pressure in patients with uncontrolled essential hypertension.
Answers are grounded in this paper and cite their sources.
Telmisartan was associated with higher BP target attainment in primary care hypertension; extends real-world data but leaves open comparative efficacy.
PURPOSE: Although elevated blood pressure (BP) predicts future cardiovascular events, recommended BP targets often is not reached in the general community. In a clinical real-life setting we evaluated BP impact and tolerability of the angiotensin-II receptor blocker telmisartan in patients with essential hypertension. PATIENTS AND METHODS: Patients in this observational study not at target BP started or switched to telmisartan monotherapy (40 or 80 mg) or a fixed-dose combination of telmisartan and hydrochlorothiazide (HCT) 80 mg/12.5 mg. Office and 24-hour ambulatory BP (AMBP) were measured before and after 8 weeks of treatment and physicians reported perceived drug efficacy and tolerability as "Very good", "Good", "Moderate" or "Bad". RESULTS: 100 patients (34% female, 60 years, BMI 29.4 kg/m(2), mean office BP 159/92 mmHg) of whom 38% were treatment naïve and 30%, 17%, 9% and 6% respectively were on 1, 2, 3 or 4 BP-lowering drugs, completed 8 weeks of treatment. The proportion of patients with office BP < 140/90 mmHg increased from 3% to 54% for systolic (P < 0.001), 38% to 75% for diastolic (P < 0.001), and 2% to 45% for systolic and diastolic BP (P < 0.001). A significant effect on BP levels was seen in patients being either treatment naïve or on 1 to 3 BP-lowering drugs at study entry, whereas no BP improvement occurred in those who switched from 4 drugs. Overall, mean 24-hour AMBP was reduced from 141/85 to 131/79 mmHg (P < 0.001). Drug efficacy and tolerability were perceived as "Very good" or "Good" by 44%/34% and 66%/27%, respectively. No drug discontinuations or serious adverse events were observed. CONCLUSIONS: In this observational study, telmisartan 40 to 80 mg, or the fixed-dose combination telmisartan 80 mg/HCT 12.5 mg, significantly increased the number of patients reaching target BP < 140/90 mmHg if treatment naïve or previously receiving 1 to 3 BP-lowering drugs. The BP reduction achieved was sustained for 24-hour and treatment tolerability was high.
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Johansen et al. (2010) conducted an observational in Essential hypertension (n=100). Telmisartan (with or without hydrochlorothiazide) vs. Baseline (pre-treatment) was evaluated on Proportion of patients reaching target office blood pressure < 140/90 mmHg (p=<0.001). Telmisartan treatment for 8 weeks significantly increased the proportion of hypertensive patients reaching target blood pressure <140/90 mmHg from 2% at baseline to 45%.
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