The Antihypertensive Efficacy of Chlorthalidone and Telmisartan in Indian Hypertensive Patients who were Uncontrolled with Hydrochlorothiazide and Telmisartan Combination-A Prospective and an Open Label Study

Abstract

Objective: The primary objective of this study was to evaluate the antihypertensive efficacy of the chlorthalidone and telmisartan combination in Indian hypertensive patients who remained uncontrolled after taking the hydrochlorothiazide and telmisartan combination. Methods:A total of 100 eligible patients were enrolled in this prospective, open label study. The patients were given telmisartan (40 mg) and chlorthalidone (12.5 mg), who had not achieved the target blood pressure (140/90 mmHg) despite taking the combination of telmisartan (40 mg) and hydrochlorothiazide (12.5 mg). The assessment was done at the end of 4 weeks and 8 weeks. Results:The mean SBP and DBP after taking telmisartan (40 mg) and hydrochlorothiazide (12.5 mg) were 154.88±9.57 (range 144 to 160) mmHg and 99.37±2.78 (range 92 to 106).At the end of 4 weeks of being on telmisartan (40 mg) and chlorthalidone (12.5 mg), the mean SBP and DBP were 145.56±5.12 (range 134 to 158) mmHg and 95.14±4.27 (range 84 to 100) mmHg. Significant falls in the SBP (5.32±2.64) and DBP (4.18±2.48) were noted at the end of the 4 week therapy. They were sustained at the end of 8 weeks also. The SBP target (<140 mmHg) was achieved in 24 % patients. The DBP target (<90 mmHg) was achieved in 19% patients. The combined SBP and DBP target (<140/90 mmHg) was achieved in 15% patients. No significant clinical adverse events were reported. Similar falls in the SBP and DBP were noted in the subgroups (smokers, females, diabetics, etc). Conclusions:The hypertensive patients who do not achieve the target blood pressures on telmisartan and hydrochlorothiazide can be switched on to the telmisartan and chlorthalidone combination. This combination is effective and well tolerated.

Fixed-dose Combination of Metoprolol, Telmisartan, and Chlorthalidone for Essential Hypertension in Adults with Stable Coronary Artery Disease: Phase III Study

“…A prospective, open-label study in India evaluated the efficacy of the combination of chlorthalidone and telmisartan in patients with hypertension who did not respond to hydrochlorothiazide and telmisartan combination. Chlorthalidone and telmisartan combination was found to be effective and well tolerated [46]. Overall, the efficacy and safety of the individual components (metoprolol, telmisartan, and chlorthalidone) have been established in confirmatory clinical studies and approved in India [47][48][49].…”

Expert Opinion on Hypertension Management: An Indian Observational Study

“…There is no published Indian data on this parameter and this can be a valuable insight for the better management of hypertension in chronic smokers. Diuretics play an important role in management of hypertension along with ARBs, CCBs, and have been used for >50 years (22) . In our survey, 53% of the doctors chose chlorthalidone, as a diuretic for the management of hypertension, Sagarad et al (22) showed that among patients with hypertension who do not achieve the goal blood pressures on telmisartan and hydrochlorothiazide can be switched on to the telmisartan and Chlorthalidone combination which is effective and well tolerated (22) .…”

“…Diuretics play an important role in management of hypertension along with ARBs, CCBs, and have been used for >50 years (22) . In our survey, 53% of the doctors chose chlorthalidone, as a diuretic for the management of hypertension, Sagarad et al (22) showed that among patients with hypertension who do not achieve the goal blood pressures on telmisartan and hydrochlorothiazide can be switched on to the telmisartan and Chlorthalidone combination which is effective and well tolerated (22) . Furthermore, Dyslipidemia, was observed as the most common co-morbid condition by 46% of the doctors as compared to Diabetes Mellitus, Hypothyroidism and Chronic Kidney disease.…”

To Evaluate the Safety and Efficacy of Amlodipine and Chlorthalidone in Combination With Telmisartan in Hypertensive Patients Attending Tertiary Care Centre, Telangana

“…According to Suresh V Sagarad et al [13], the telmisartan and chlorthalidone combination was effective in the patients who remained uncontrolled after being on telmisartan and HCTZ combination in a similar dosage.…”