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| |  Telmisartan Plus Hydrochlorothiazide Appears Beneficial for Older Patients With Hypertension By Jerry Ingram ORLANDO, FL -- May 17, 2005 -- MicardisPlus, a combination of telmisartan and hydrochlorothiazide (HCTZ), appears to control systolic blood pressure more effectively over a 24-hour period than amlodipine plus HCTZ, researchers reported here May 12th at the 2005 American Geriatrics Society Annual Scientific Meeting. "The helpful thing about our study is that it shows that we can treat hypertension in older patients to a level where one might have thought patients would have quite a bit of dizziness – the blood pressure can be diminished to a very good level without any side effects," reported principal investigator Steen Neldam, MD, an associate professor at the University of Copenhagen, Denmark. The study, a comparison of telmisartan plus HCTZ with amlodipine plus HCTZ in older patients with predominantly systolic hypertension (ATHOS), is part of a larger study called PROTECTION (Programme of Research to shOw Telmisartan End-organ proteCTION). For this prospective study, researchers conducted a randomized, open-label, blinded-endpoint study, enrolling 683 patients with systolic blood pressure of >140 mg and diastolic blood pressure of less than or equal to 95 mmHg. In addition, all patients had a 24-hour mean ambulatory systolic blood pressure >125 mmHg and were at least 60 years of age. The clinicians randomized patients, placing them into one of two treatment groups. In 354 patients, they administered telmisartan (40 mg for 2 weeks titrating up to 80 mg for 6 weeks) and then telmisartan (80 mg) plus HCTZ (12.5 mg) for 6 weeks. The second group (329 patients) received amlodipine (5 mg titrating up to 10 mg for 6 weeks) and then amlodipine (10 mg) plus HCTZ (12.5 mg) for 6 weeks. Researchers evaluated efficacy of the two treatment options based on 24-hour ambulatory blood pressure results. They found that patients in the telmisartan/HCTZ group experienced greater reductions in systolic blood pressure compared with those in the amlodipine/HCTZ group over the 24-hour study period (19.3 mmHg vs. 17.2 mmHg; P = .001). In addition, Dr. Neldam's team noted that systolic blood pressure control rates were greater in the telmisartan/HCTZ group, with 69.5% of these patients attaining 24-hour mean systolic blood pressure of <130mmHg compared to only 58.3% of those in the amlodipine/HCTZ group (P = .0175). The researchers reported that fewer patients experienced adverse events with the telmisartan combination – only 8% vs. 33.4% of those patients taking the amlodipine combination. The most common adverse event was peripheral edema, occurring in 1.2% of the telmisartan/HCTZ group and 24.3% of the amlodipine/HCTZ group. Boehringer Ingelheim, maker of MicardisPlus, funded the study.
[Presentation title: Telmisartan + Hydrochlorothiazide versus Amlodipine + Hydrochlorothiazide in Older Patients With Predominantly Systolic Hypertension.]
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