CONSENSUS TOWARDS THE UTILISATION OF BISOPROLOL IN COMBINATION WITH TELMISARTAN IN INDIAN PATIENTS WITH HYPERTENSION

Abstract

Objective: To formulate a consensus statement for the utilization of bisoprolol in combination with telmisartan based on the contemporary evidence and the real-world experiences of the Indian cardiologists Design and method: A virtual collaborative educational initiative was convened from November 2022, to December 2022, through a series of 8 nationwide virtual interactive meetings by leading cardiologists (n = 90) at the forefront of cardiovascular care (CERTAIN Study Group). The cumulative clinical experience was approximately 2,500-man-years, who rated their level of agreement for 14 questions with each item on a 5-point Likert scale. This was preceded by a contemporary evidence-based discussion on the contemporary updates for hypertension and for the combination of bisoprolol (beta blocker) and telmisartan (ARB). Weighted mean for the Likert scale was calculated and consensus was pre-defined as a score > 100. GraphPad 9.4.0 and ANOVA were used for statistical analysis. Results: The highest agreement score was for the concurrence for the diabetes have consistently higher risks over the whole BP range (127), bisoprolol is a suitable choice for management of Left Ventricular Dysfunction post MI (124), bisoprolol has impactful clinical implications for modulation of resting heart rate in patients with CAD (123), telmisartan has a distinctive pharmacological properties that translate into a clinically relevant approach for management of hypertension (122), bisoprolol is beneficial in patients with hemodialysis (120), bisoprolol in combination with telmisartan is useful in patients with co-morbidities (115), bisoprolol has modulatory properties for the impact of remodelling in patients with heart failure (111), bisoprolol in combination with telmisartan is a useful tool to manage hypertension. (Figure). The highest mean response scores (±SD, 95% CI) for consensus were for agree (25±10, 95% CI 19 to 31) followed by strongly agree (14±11, 95% CI 7.6 to 20) Conclusions: We observed a high preference for the combination of bisoprolol with telmisartan for use in patients with hypertension with comorbidities. We attribute this to a high level of perceived effectiveness, based on the recent clinical trials.