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  • Title: Effect of switching from amlodipine to combination therapy with telmisartan and low-dose hydrochlorothiazide.
    Author: Ando K, Isshiki M, Takahashi K, ONgoing Evaluation of depressor effect And Safety of combination therapy with Telmisartan and low-dose hydrochlorothiazide (ONEAST) Study Group.
    Journal: Hypertens Res; 2009 Sep; 32(9):748-52. PubMed ID: 19590506.
    Abstract:
    One of the most effective pairs in combination therapy is that of an inhibitor of the renin-angiotensin system (RAS) and a low-dose thiazide diuretic. Possible candidates for this combination therapy are hypertensive patients with blood pressure (BP) that is not controlled by a calcium channel blocker (CCB). Thus, we characterized the antihypertensive effect of the combination of telmisartan and low-dose hydrochlorothiazide in patients with hypertension that was not controlled by amlodipine, which is the most common CCB. A total of 75 patients with BP levels higher than 140/90 mm Hg, treated with 5 mg per day of amlodipine for at least 3 months, were divided into groups that were switched to treatment with 40-80 mg per day of telmisartan plus 12.5 mg per day of hydrochlorothiazide (TH, n=37) or that were continuously treated with 5-7.5 mg per day of amlodipine (Am, n=38). After 12 weeks of treatment, the mean BP level was significantly lower in the TH group than in the Am group (decrease in BP: -9.9+/-11.4 vs. -3.7+/-8.9 mm Hg, P<0.02; normalization rate: 67.6 vs. 30.3%, P<0.01). Serum uric acid was slightly higher in the TH group, but other laboratory data were not different between groups. Therefore, it is suggested that the combination of a RAS inhibitor and a low-dose thiazide is useful if treatment with a CCB cannot control BP in patients with hypertension.
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