TELMISARTAN/AMLODIPINE SINGLE-PILL COMBINATION THERAPY TO ACHIEVE BLOOD PRESSURE GOAL VALUES IN HYPERTENSIVE PATIENTS IN GPS’ PRACTICE – AN OBSERVATIONAL STUDY

Abstract

Objective: Current ESC/ESH Guidelines suggests a simple therapeutic strategy to increase treatment effectiveness: the application of single pill combination (SPC) of a RAS inhibitor with a calcium channel antagonist or a diuretic as a first step. Our primary goal was to assess the percentage of patients reaching optimal BP goal (130/80 mmHg) after 12 weeks of SPC therapy with telmisartan/amlodipine according to office BP measurements in hypertensive patients treated by general practitioners (GPs) in regular clinical practice. We also examined the percentage of patients achieving primary target BP (<140/90 mmHg). Design and method: After given informed consent, 729 patients with primary hypertension from 120 GP’s offices participated in this multicentre, observational, non-interventional, prospective study. Results: The average age of the patients was 62 ± 12 years, 357 patients (49.8%) of the population was male. The average office BP at baseline was 150 ± 17/88 ± 10 mmHg, and decreased to 130 ± 8.1/78 ± 6.1 mmHg at 12 week (p < 0.05). Pulse rate has decreased as well (from 80 ± 9.8/min to 75 ± 6.3/min). At baseline, 10.1 % of the patients were at optimal systolic BP goal (<130 mmHg), 15.8% at optimal diastolic BP goal (<80 mmHg) and only 5.5% simultaneously at systolic and diastolic BP goal (<130/80 mmHg). By the end of the observational period the percentage of patients reaching these optimal BP goal values increased to 51.6%, 54.1% and 33.0%, respectively. At baseline 19.2% of patients had BP less than 140/90 mmHg, which increased to 87.1% by the end of the study. Dose adjustments during the study were made in only 3 % of patients (n = 22). Patients tolerated SPC telmisartan/amlodipine well, 95% of the patients continued medication after study conclusion. Conclusions: The introduction of a SPC therapy of telmisartan/amlodipine increases the success rate of treatment during a relative short period. High proportion of patients were able to lower within 3 months their BP levels under 140/90 mmHg, however, only one third of the patients reached optimal target BP. Main possible reasons for this was the low rate of dose adjustment during the study. The study was sponsored by KRKA Hungary Ltd.