April 8, 2021Cardiology and TherapyOpen Access

Effectiveness of Telmisartan on Blood Pressure Control in Hypertensive Patients in India: A Real-World Retrospective Study from Electronic Medical Records

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Why the study?

Telmisartan effectiveness has been reported in Indian clinical trials, but real-world data in Indian patients with essential hypertension remain limited.

Does telmisartan as monotherapy or in combination with other antihypertensive drugs reduce blood pressure in adult patients with essential hypertension?

Structured PICO

Does telmisartan as monotherapy or in combination with other antihypertensive drugs reduce blood pressure in adult patients with essential hypertension?

Population

1,304 adult patients in India diagnosed with essential hypertension (≥ 140/90 mmHg)

Intervention

Telmisartan as monotherapy or in combination with other antihypertensive drugs (AHDs)

Outcome

Change in systolic and diastolic blood pressure (SBP and DBP) after a month of treatmentsurrogate

Telmisartan, either as monotherapy or in combination with other agents, effectively reduces blood pressure in Indian patients with essential hypertension in a real-world setting.

Implication

Real-world data support telmisartan in Indian hypertension; leaves open need for randomized confirmation before broader adoption.

Abstract

INTRODUCTION: The effectiveness of telmisartan has been reported in Indian clinical trials; however, real-world data are limited. We aimed to provide real-world evidence regarding the effectiveness of telmisartan as monotherapy or in combination with other antihypertensive drugs (AHDs) in Indian patients with essential hypertension. METHODS: Electronic medical record data of adult patients diagnosed with essential hypertension (≥ 140/90 mmHg) and who were prescribed telmisartan as mono- or add-on therapy were retrospectively analyzed. Patients were classified according to the number of AHD classes prescribed on initiating telmisartan. Change in systolic and diastolic blood pressure (SBP and DBP) after a month of treatment and the proportion of patients who achieved treatment goals according to the 2018 European Society of Cardiology/European Society of Hypertension guidelines were evaluated. RESULTS: A majority (90.6%) of the 1304 patients included in the study were on telmisartan monotherapy or telmisartan + 1 AHD. The mean (95% confidence interval [CI]) change in the telmisartan monotherapy group was SBP (-13.3 [-14.6, -12.0] mmHg) and DBP (-7.2 [-7.9, -6.5] mmHg), and the mean (95% CI) change in the telmisartan + 1 AHD group was SBP (-10.8 [-13.1, -8.5] mmHg) and DBP (-6.5 [-7.7, -5.3] mmHg) (P < 0.001 for all). SBP and DBP goals were achieved by 35.9% and 47.3% of patients on telmisartan monotherapy and by 35.9% and 46.8% of patients on telmisartan + 1 AHD. Among patients with comorbid diabetes, the mean (95% CI) change in the telmisartan monotherapy group was SBP (-13.3 [-15.0, -11.6] mmHg) and DBP (-7.3 [-8.2, -6.5] mmHg), and the mean (95% CI) change in the telmisartan + 1 AHD group was SBP (-13.0 [-16.5, -9.5] mmHg) and DBP (-6.9 [-8.7, -5.1] mmHg) (P < 0.001 for all). SBP and DBP goals were achieved by 31.7% and 39.7% of patients on telmisartan monotherapy and by 31.9% and 41.8% of patients on telmisartan + 1 AHD. CONCLUSION: Telmisartan may be a good candidate for blood pressure control in Indian patients with essential hypertension and comorbidities.