The effects of telmisartan alone or in combination with hydrochlorothiazide on morning home blood pressure control: The SURGE 2 practice-based study

Abstract

SURGE 2, a large-scale, practice-based study in 10 countries, evaluated the effects of telmisartan alone or with hydrochlorothiazide (HCTZ) on morning (06:00–11:59) home blood pressure (HBP) control. Hypertensive patients (clinic blood pressure [BP] ≥ 140/90 mmHg) received telmisartan 40 or 80 mg either alone or in combination with HCTZ 12.5 mg for 8 weeks. Treatment could be adjusted if clinic BP remained ≥ 140/90 mmHg. Clinic BP was measured in the morning prior to medication, and seated HBP monitoring was performed, three times per day, 2 days per week. A total of 25,882 patients were included (71% were previously using antihypertensives). There was a statistically significant (all p < 0.001) reduction in mean morning, lunchtime and evening HBP following treatment with telmisartan/telmisartan plus HCTZ, and morning HBP control increased from 10.6–19.8% to 51.1–64.6%. Similar improvements were observed for lunchtime (from 20.6–26.0% to 57.7–70.5%) and evening (from 21.3–31.4% to 59.0–68.8%). The morning HBP response ranged from 62.6–67.5% (systolic BP) and from 81.4–87.0% (diastolic BP). Adverse events were reported by 1.2% of patients. Telmisartan alone or with HCTZ improved morning HBP control and maintained a smooth HBP profile throughout the day in a real-life setting.

Key Words::

• Home blood pressure monitoring
• hydrochlorothiazide
• morning blood pressure control
• telmisartan

Acknowledgements

The authors would like to thank all investigators comprising the SURGE Steering Committee for their participation, in terms of patient involvement, data collection and analyses. Writing and editorial assistance was provided by PAREXEL, which was contracted by Boehringer Ingelheim International GmbH for these services. Data analysis was provided by QUINTILES. The authors meet the criteria for authorship as recommended by the International Committee of Medical Journal Editors and were fully responsible for all content and editorial decisions, and were involved at all stages of manuscript development. The author received no compensation related to the development of the manuscript. The SURGE series of trials was sponsored by Boehringer Ingelheim International GmbH.

Declaration of interest: Josep Redon, Grzegorz Bilo and Gianfranco Parati declare no conflict of interest. No remuneration was received by investigators for participation in this study.