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Long-term efficacy and tolerability of telmisartan as monotherapy and in combination with other antihypertensive medications.

Author(s): Neutel JM, Klein C, Meinicke TW, Schumacher H

Affiliation(s): Orange County Heart Institute & Research Center, Orange, California, USA. JMNeutel@aol.com

Publication date & source: 2002, Blood Press., 11(5):302-9.

Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial

This open-label, multicenter, extension study assessed the efficacy and tolerability of telmisartan 80 mg administered alone or with HCTZ and/or other antihypertensive agents over a maximal 1-year treatment period. Of the 690 patients with mild-to-moderate hypertension completing the preceding 6-week, randomized trial (comparing telmisartan 80 mg with losartan 50 mg/HCTZ 12.5 mg combination therapy), 489 patients (70.9%) continued in this extension study. A fixed-titration regimen was employed: all patients received telmisartan 80 mg initially, with the stepwise addition of HCTZ 12.5 mg, HCTZ 25 mg and/or other antihypertensives to attain diastolic blood pressure (DBP) control (<90 mmHg). At the final visit, DBP control was achieved in 70.0% (194/277) of patients maximally titrated to telmisartan 80 mg, 55.8% (48/86) titrated to telmisartan 80 mg + HCTZ 12.5 mg, 54.7% (47/86) titrated to telmisartan 80 mg + HCTZ 25 mg, and 64.7% (22/34) titrated to telmisartan 80 mg + other antihypertensive +/- HCTZ (12.5 or 25 mg). The DBP and systolic blood pressure (SBP) reductions observed in the preceding randomized trial continued during extension treatment. Progressively greater blood pressure reductions occurred with the sequential addition of HCTZ and other antihypertensives. Adding HCTZ 12.5 mg to telmisartan 80 mg was particularly effective at enhancing antihypertensive efficacy. All treatments were well tolerated. Thus, telmisartan 80 mg administered alone or with HCTZ (12.5 or 25 mg) and/or other antihypertensives maintains a clinically significant therapeutic effect over the long term in patients with mild-to-moderate hypertension.

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