[Background: Current European guidelines on the management of hypertension suggests a simple and easily applicable therapeutic strategy to increase effectiveness. Important component of this strategy is the application of single-pill combination (SPC) of RAS inhibitor in combination with calcium antagonists or diuretics as a first step.
Primary objective: To assess the percentage of patients reached goal blood pressure ranges after 12 weeks of fix dose combination therapy with telmisartan plus amlodipine according to office blood pressure measurements in hypertensive patients treated by general practitioners (GPs).
Patients and methods: After informed consent, 729 patients of 63 GP’s office participated in this multicentre, non-interventional, prospective data collection study. The intention-to-treat (ITT) population was 717, and primary endpoint was analysed in 690 patients (per protocol [PP] population). There were two visits during the study. Blood pressure was measured in all patients at the time of the enrollment and at the second and final visit.
Results: The average age of the patients was 62±12 years, 55% of the patients were younger than 65 years, 357 patients (49.8%) of the population was male. The average office blood pressure 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 blood pressure goal, 15.8% at optimal diastolic blood pressure goal and only 5.5% simultaneously at systolic and diastolic goal. By the end of the observational period the percentage of patients reached optimal BP goal values increased to 51.6%, 54.1% and 33.0%, respectively (systolic, diastolic, systolic and diastolic). Also the proportion of those who achieved primary target BP below 140/90 mmHg was higher. At baseline 19.2% of patients had BP below 140/90 mmHg, which increased to 87.1% by the end of the study. Patients tolerated SPC telmisartan/amlodipine well, 95% of the patients continued to receive prescribed medication after study conclusion.
Conclusion: These real world data shows that the introduction of a fix dose combination therapy after free combination therapy increases the success rate of treatment during a relative short period, however many of the patients would still need higher doses or additional therapy after 3 months in order to achieve the optimal BP target levels. ]