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

Figures & data

Figure 1. Study design and patient disposition. BP, blood pressure; DBP, diastolic blood pressure; HCTZ, hydrochlorothiazide; SBP, systolic blood pressure.

Table I. Mean (standard deviation)^a baseline characteristics according to previous therapy.

	Previously untreated patients (n = 7518)	Previously treated patients (n = 18,364)
Age (years)	55 (12.5)	59 (12.4)
Body mass index (kg/m^2)	30.2 (9.69)	29.8 (9.31)
Clinic SBP (mmHg)	155 (18.5)	158 (18.5)
Clinic DBP (mmHg)	92 (11.0)	92 (11.3)
Heart rate (beats/min)	78 (9.5)	76 (10.8)
Male, n (%)	3609 (48.0)	7842 (42.7)
Family history of CV disease, n (%)	1851 (24.6)	5372 (29.3)
Hypercholesterolaemia, n (%)	2008 (26.7)	7342 (40.0)
Diabetes, n (%)	1073 (14.3)	4503 (24.5)
Coronary heart disease, n (%)	241 (3.2)	2267 (12.3)
Left ventricular hypertrophy, n (%)	162 (2.2)	1599 (8.7)
Transient ischaemic attack/stroke, n (%)	108 (1.4)	773 (4.2)
Heart failure, n (%)	48 (0.6)	579 (3.2)
Albuminuria, n (%)	120 (1.6)	700 (3.8)
Antihypertensive therapy^b, n (%)
ARB, n (%)		2994 (16.3)
Diuretic, n (%)		5946 (32.4)
ACE inhibitor, n (%)		6733 (36.7)
Beta-blocker, n (%)		5415 (29.5)
Calcium antagonist, n (%)		4327 (23.6)
Other, n (%)		1570 (8.5)

SBP, systolic blood pressure; DBP, diastolic blood pressure; CV, cardiovascular; ARB, angiotensin II receptor blocker; ACE, angiotensin-converting enzyme. ^aUnless otherwise stated. ^b≥ One antihypertensive agent.

Table II. Treatment allocation at final visit (n = 25,882).

Subgroup	Patients, n
Previously untreated (n = 7518)
Telmisartan only	4872
Telmisartan and other antihypertensive medication	285
Telmisartan and HCTZ only	1547
Telmisartan and HCTZ and other antihypertensive medication	214
Data on treatment allocation missing	600
Previously treated (n = 18,364)
Telmisartan only	6851
Telmisartan and other antihypertensive medication	4031
Telmisartan and HCTZ only	4144
Telmisartan and HCTZ and other antihypertensive medication	2288
Data on treatment allocation missing	1050

HCTZ, hydrochlorothiazide.

Figure 2. Blood pressure reduction in (A) previously untreated and (B) previously treated patients following 8 weeks of treatment with telmisartan either alone or in combination with HCTZ. HCTZ, hydrochlorothiazide; DBP, diastolic blood pressure; SBP, systolic blood pressure.

Table III. Blood pressure (BP) control rates (%) initially and after 8 weeks of treatment with telmisartan either alone or in combination with HCTZ.

	Previously treated patients		Previously untreated patients
BP	Telmisartan, initial/final	Telmisartan plus HCTZ, initial/final	Telmisartan, initial/final	Telmisartan plus HCTZ, initial/final
Clinic < 140/90 mmHg (n)	10.8/72.1^a (n = 3097)	5.5/63.5^a (n = 2017)	10.0/70.8^a (n = 552)	5.4/63.8^a (n = 221)
Morning home BP < 135/85 mmHg (n)	16.8/58.0^a (n = 4788)	13.1/51.1^a (n = 3005)	19.8/64.6^a (n = 2874)	10.6/53.7^a (n = 977)
Lunchtime home BP < 135/85 mmHg (n)	21.6/64.3^a (n = 1882)	20.6/57.7^a (n = 1077)	26.0/70.5 (n = 766)	20.8/66.5^b (n = 284)
Evening home BP < 135/85 mmHg (n)	24.8/64.0^a (n = 1876)	21.3/59.0^a (n = 1077)	31.4/67.8 (n = 768)	25.2/68.8 (n = 282)

HCTZ, hydrochlorothiazide. ^ap < 0.0001. ^bp < 0.01 versus initial measurements.

Table IV. Response rates (%) after 8 weeks of treatment with telmisartan either alone or in combination with HCTZ.

	Previously treated patients		Previously untreated patients
BP	Telmisartan	Telmisartan plus HCTZ	Telmisartan	Telmisartan plus HCTZ
Clinic
Systolic	76.7 (n = 3106)	78.1 (n = 2029)	78.1 (n = 553)	82.0 (n = 222)
Diastolic	80.2 (n = 3102)	78.4 (n = 2022)	77.8 (n = 553)	77.4 (n = 221)
Morning home BP
Systolic	63.6 (n = 4795)	66.4 (n = 3016)	62.6 (n = 2879)	67.5 (n = 978)
Diastolic	82.1 (n = 4788)	81.4 (n = 3005)	87.0 (n = 2874)	82.5 (n = 977)
Lunchtime home BP
Systolic	58.0 (n = 1882)	59.1 (n = 1080)	56.1 (n = 766)	60.4 (n = 285)
Diastolic	81.9 (n = 1883)	83.3 (n = 1077)	84.1 (n = 766)	84.2 (n = 284)
Evening home BP
Systolic	50.8 (n = 1877)	53.9 (n = 1080)	48.8 (n = 768)	51.8 (n = 282)
Diastolic	82.8 (n = 1876)	82.3 (n = 1077)	84.9 (n = 768)	83.0 (n = 282)

BP, blood pressure; HCTZ, hydrochlorothiazide.

Table V. Most frequently reported (>1%) adverse events (n = 25,882).

	Total, n (%)
Any adverse event	301 (1.2)
Back pain	18 (0.1)
Diarrhoea	50 (0.2)
Dizziness	50 (0.2)
Fatigue	17 (0.1)
Headache	55 (0.2)
Hypotension	38 (0.1)
Nausea	36 (0.1)
Vertigo	29 (0.1)