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Abstract
Objective:
Hypertensive patients with metabolic risk factors, including obesity, diabetes, and metabolic syndrome, often require a combination of antihypertensive agents to achieve blood pressure (BP) targets. This article considers the evidence supporting telmisartan/amlodipine combination therapy for the treatment of hypertension in patients with metabolic risk factors.
Methods:
Clinical trials of telmisartan/amlodipine at doses of 40–80 mg/5–10 mg (T40–80/A5–10) in free, fixed-dose and single-pill combinations were identified through electronic searches (MEDLINE and congress abstracts) up to and including June 2012, and from the Boehringer Ingelheim (BI) trial database. All identified trials were reviewed for data on hypertensive patients with obesity, diabetes, or both. Post-hoc subgroup analyses were carried out using the BI database to determine the relevant information if it was not previously reported.
Results:
Thirteen clinical trials including 6886 patients were identified with data relevant for inclusion in this review. The telmisartan/amlodipine combination allowed a high proportion of hypertensive patients with metabolic conditions to achieve BP targets, particularly among patients who had previously failed to achieve BP targets with monotherapy. BP reductions and goal rate achievement were similarly high among patients with and without the presence of metabolic risk factors. BP reductions were maintained throughout the 24 h dosing period, and 24 h goal rates were obtained in a high proportion of patients. Particularly large reductions in BP with telmisartan/amlodipine were recorded among patients with severe hypertension (systolic BP ≥180 mmHg).
Conclusions:
The results of this post-hoc analysis further support the ability of the telmisartan/amlodipine combination to effectively reduce BP in hypertensive patients with obesity, diabetes, or metabolic syndrome, enabling the majority of patients to achieve target BP. This combination is also well tolerated, and may be considered a suitable option for these added-risk hypertensive patients.
Transparency
Declaration of funding
This study was funded by Boehringer Ingelheim, GmbH & Co. KG, Ingelheim, Germany.
Declaration of financial/other relationships
L.L. and H.S. have disclosed that they are employees of Boehringer Ingelheim.
CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.
Acknowledgements
The authors were fully responsible for all content and editorial decisions, they were both involved at all stages of manuscript development and have approved the final version of the review that reflects the authors’ interpretation and conclusions. Medical writing assistance, supported financially by Boehringer Ingelheim, was provided by Emma Fulkes PhD of PAREXEL during the preparation of this review.