Early combination therapy with telmisartan plus amlodipine for rapid achievement of blood pressure goals

• Published in: International journal of clinical practice (Esher) Vol. 67; no. 9; pp. 843 - 852
• Main Authors: Neldam, S., Dahlöf, B., Oigman, W., Schumacher, H.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.09.2013; Hindawi Limited
• Subjects: Aged; Amlodipine - therapeutic use; Antihypertensive Agents - therapeutic use; Benzimidazoles - therapeutic use; Benzoates - therapeutic use; Blood pressure; Blood Pressure - drug effects; Cardiovascular disease; Double-Blind Method; Drug Combinations; Drug therapy; Female; Humans; Hypertension - drug therapy; Hypertension - physiopathology; Male; Middle Aged; Randomized Controlled Trials as Topic; Risk factors; Treatment Outcome
• ISSN: 1368-5031; 1742-1241
• DOI: 10.1111/ijcp.12180

Summary Background Rapid and sustained blood pressure (BP) goal attainment is important to reduce cardiovascular risk. Initial use of combination therapy may improve BP goal attainment. Methods The Boehringer Ingelheim trial database was searched for randomised, double‐blind studies comparing telmisartan/amlodipine combination therapy with monotherapy. Eight studies were identified. Eight separate analyses were used to compare combination therapy with respective monotherapies at the earliest available time points (weeks 1, 2 and/or 4). Results In patients initiated on combination therapy, greater systolic BP (SBP)/diastolic BP (DBP) reductions were seen with combination therapy (p < 0.0001); BP (< 140/90 mmHg), SBP (< 140 mmHg) and DBP (< 90 mmHg) goal attainment rates were significantly higher with combination therapy at all time points. In patients uncontrolled by monotherapy, greater SBP/DBP reductions were seen with combination therapy (p < 0.05 in all but one measure), and all goal attainment rates were significantly higher with combination therapy, except in one measure. Conclusion Many people can achieve their BP targets when taking a combination of telmisartan and amlodipine after failing to do so with monotherapy. Furthermore, BP targets can be achieved more rapidly using a combination of telmisartan and amlodipine as initial therapy than with either monotherapy. Linked Comment: Wierzbicki and Ferro. Int J Clin Pract 2013; 67: 822–4.