An update on telmisartan/hydrochlorothiazide combinations for the management of hypertensive patients with additional cardiovascular risk factors

Abstract

International hypertension guidelines endorse the use of combination therapy to achieve blood pressure control in the majority of patients. Angiotensin AT1 receptor blockers, in combination with diuretics, are among the preferred combinations, with telmisartan plus hydrochlorothiazide (HCTZ) being an effective and well-tolerated combination. This article provides an up-to-date review of the existing data on telmisartan/HCTZ combination for the management of hypertension in patients with additional cardiovascular risk factors, including reports emerging from a number of recent clinical trials and secondary analyses of older trials. The accumulated evidence from clinical trials demonstrates that telmisartan/HCTZ combinations are effective and well tolerated in patients with mild-to-severe hypertension, including subgroups of patients with cardiovascular risk factors such as advanced age, obesity, chronic kidney disease, diabetes mellitus and treatment-resistant hypertension.

Keywords::

• diabetes mellitus
• high cardiovascular risk
• hydrochlorothiazide
• hypertension
• obesity
• renal impairment
• telmisartan

Financial & competing interests disclosure

S Kjeldsen has received lecture honoraria from AstraZeneca, Bayer, Medtronic, Merck Sharp & Dohme and Takeda, and consultancy honoraria from Bayer, Medtronic, Takeda and Serodeus. G Mancia has received speaker’s fee, consultation fee or research grants from Boehringer Ingelheim, CVRx, Daiichi Sankyo, Medtronic Vascular Inc, Menarini Int, Merck Serono, Novartis, Pfizer Inc, Recordati, Servier, Siron and Takeda. M Mattheus is an employee of Boehringer Ingelheim Pharma GmbH & Co. KG. R Schmieder has received consulting, lecture fees and research grants from Boehringer Ingelheim and other companies manufacturing angiotensin receptor blockers, angiotensin-converting enzyme inhibitors and other blood pressure–lowering drugs. T Unger has received lecture honoraria from AstraZeneca, Bayer, Boehringer Ingelheim, Merck, Novartis, sanofi-aventis, Takeda, and Vicore Pharma and is on the advisory boards of AstraZeneca, Bayer, Boehringer Ingelheim, Merck, Novartis, sanofi-aventis, Takeda and Vicore Pharma. The authors were fully responsible for all content and editorial decisions, were involved at all stages of manuscript development and have approved the final version of the review that reflects the authors’ interpretation and conclusions. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing assistance, supported financially by Boehringer Ingelheim, was provided by D Russell and A Jeans of PAREXEL, during the preparation of this review. Boehringer Ingelheim was given the opportunity to check the data used in the manuscript for factual accuracy only.