Safety and efficacy of standard dose triple combination in treatment of primary hypertension

A new study found that standard dose triple combination therapy of chlorthalidone 25 mg with telmisartan 80 mg plus amlodipine 5 mg was safe and effective for treating primary hypertension. This study’s results were published in the Journal of Clinical Hypertension.

This phase 3, multicenter, randomized, double-blind, active-controlled trial enrolled 374 patients. The participants were randomized to TEL/AML/CHTD group (triple combination), receiving telmisartan 40 mg/amlodipine 5 mg/chlorthalidone 12.5 mg or TEL/AML group (dual combination), receiving telmisartan 40 mg/amlodipine 5 mg. This was followed by dose up titration to TEL 80/AML5/CHTD25mg and TEL80/AML5, respectively. Change of mean sitting systolic blood pressure (MSSBP) at week 8 was the primary endpoint of the study.

It was observed that the baseline MSSBPs/diastolic BPs were 149.9 ± 12.2/88.5 ± 10.4 mm Hg. 8 weeks post-treatment, the change of MSSBPs was found to be -19.1 ± 14.9 mm Hg (TEL/AML/CHTD) and -11.4 ± 14.7 mm Hg (TEL/AML). The achievement rates of target BP and responder rate were significantly higher in TEL/AML/CHTD. No adverse events due to medication were reported. Among the triple combination group, female patients or those aged≥ 65 years old showed a higher rate of target BP achievement than relatively young males.

Based on the above results, it was evident that the standard dose triple combination was safe and efficacious in treating primary hypertension and may be more pronounced in females or older patients.