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Effect of a fixed-dose combination of Telmisartan/S-amlodipine on circadian blood pressure compared with Telmisartan monotherapy: TENUVA-BP study

Authors
 Bong-Joon Kim  ;  Kyoung-Im Cho  ;  Hyuck Moon Kwon  ;  Seung-Min Choi  ;  Chang-Hwan Yoon  ;  Sang Wook Lim  ;  Seung-Jae Joo  ;  Nam Ho Lee  ;  Sang-Yup Lim  ;  Seong-Hoon Lim  ;  Hyo-Soo Kim 
Citation
 Clinical Hypertension, Vol.28(1) : 7, 2022-03 
Journal Title
Clinical Hypertension
Issue Date
2022-03
Keywords
Amlodipine ; Circadian rhythm ; Drug combinations ; Essential hypertension ; Telmisartan
Abstract
Background: This study evaluated the circadian efficacy of a telmisartan 40 mg/S-amlodipine 2.5 mg fixed-dose combination (Telmisartan40/S-Amlodipine2.5) compared to telmisartan 80 mg (Telmisartan80) in patients with essential hypertension who did not respond to 2-4 weeks' treatment with telmisartan 40 mg.

Methods: Eligible patients with essential hypertension (clinic mean sitting systolic blood pressure [MSSBP] ≥140 mmHg, or ≥ 130 mmHg in those with diabetes mellitus or chronic kidney disease) were randomly assigned to Telmisartan40/S-Amlodipine2.5 or Telmisartan80 for 8 weeks. All patients underwent ambulatory BP monitoring (ABPM) at baseline and 8 weeks later. Primary endpoints were changes in mean 24-h SBP and DBP on 24-h ABPM from baseline after 8 weeks. Secondary endpoints were changes in daytime, nighttime, and morning SBP and DBP, and clinic MSSBP and MSDBP.

Results: A total of 316 Korean patients were enrolled, 217 patients were randomized to treatment, and 192 patients completed the study. Compared to Telmisartan80, Telmisartan40/S-Amlodipine2.5 showed significantly better reductions in 24-h mean SBP and DBP after 8 weeks. Telmisartan40/S-Amlodipine2.5 also significantly reduced secondary endpoints compared to Telmisartan80. Among 15 adverse events (7 [Telmisartan40/S-Amlodipine2.5] and 8 [Telmisartan80]), there were five adverse drug reactions; 14 events were mild, and none were identified with significant between-group differences.

Conclusions: Telmisartan40/S-Amlodipine2.5 was tolerable and more effective than Telmisartan80 in lowering 24-h mean ambulatory BP in patients with essential hypertension not responding adequately to Telmisartan40. Our findings support the fact that the combination of S-amlodipine with telmisartan is more appropriate than increasing the dose of telmisartan monotherapy.

Trial registration: ClinicalTrials.gov , NCT02231788 . Registered 4 September 2014.
Files in This Item:
T202204962.pdf Download
DOI
10.1186/s40885-021-00184-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191254
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