EFFECTIVENESS & TOLERABILITY OF METOPROLOL ER, TELMISARTAN & CHLORTHALIDONE IN PATIENTS OF ESSENTIAL HYPERTENSION WITH STABLE CAD: INDIAN REAL-WORLD STUDY STRATIFIED BY BMI

Abstract

Objective: We conducted real world study to assess effectiveness (on blood pressure [BP; mmHg]) and tolerability of fixed dose combination (FDC) of 25/50 mg Metoprolol + 40 mg Telmisartan + 12.5 mg Chlorthalidone in treating hypertension and stable coronary artery disease (CAD). Body mass index (BMI) is one of the factors that affects hypertension and CAD. Hence, we performed this subgroup analysis to assess effectiveness of the FDC based on patients’ BMI. Design and method: A retrospective, multicenter study retrieved data over 15 months from electronic medical records of 1,810 adult patients with systolic BP greater or equal to 140 and/or diastolic BP greater or equal to 90 and stable CAD; 1,784 were treated with FDC for 24 ± 2 weeks. Mean change in BP from baseline, proportion of patients achieving target BP (systolic BP < 140 and diastolic BP < 90) and incidence of adverse events were analyzed in patients with BMI < 18.5 kg/m2 (underweight n= 9); 18.5-22.9 kg/m2 (normal n= 249), 23.0-24.9 kg/m2 (overweight n= 464) and greater or equal to 25 kg/m2 (obese n=1,062). Results: Mean changes in systolic (underweight, -33.6; normal, -29.9; overweight, -27.7; obese, -31) and diastolic BP (underweight, -12.2; normal, -11.5; overweight, -12; obese, -12.2) from baseline to 24 ± 2 weeks were significant (p<0.001), Fig 1. Proportion of patients achieving target BP at 24 ± 2 weeks in all except underweight category was >84%. Fourteen patients had adverse events; hypotension being most common. Conclusions: In a real-world setting, the FDC of Metoprolol + Telmisartan + Chlorthalidone was effective in reducing blood pressure and was well-tolerated in treating hypertension with CAD across all BMI categories. The study demonstrated significant reductions in both systolic and diastolic BP for patients with different BMI levels, highlights the potential benefits of FDC in managing hypertension in various body weight groups.