The effect of fixed combination therapy with telmisartan/ amlodipine on cardiometabolic risks in patients with arterial hypertension
Received: 2026-06-17
Published: 2026-06-29
Abstract
Aim. To evaluate the antihypertensive efficacy, effects on cardiometabolic risk factors, regression of target organ damage, and safety of 6-month fixed-combination therapy with telmisartan/amlodipine in patients with arterial hypertension (AH).
Materials and Methods. The study enrolled 52 patients aged 18–65 years (mean age 51.90±13.84 years) with grade I–II AH according to the ESH 2023 classification. All patients received a fixed combination of telmisartan/amlodipine Assessment was performed at baseline and after 6 months, including office blood pressure measurement, echocardiography, applanation tonometry, duplex scanning of the carotid arteries, and evaluation of glucose, lipids, uric acid, hepatic transaminases, creatinine with calculation of glomerular filtration rate (GFR), and microalbuminuria (MAU) in morning urine.
Results. After 6 months of fixed-combination telmisartan/amlodipine therapy, systolic blood pressure (SBP) decreased by 19.54% and diastolic blood pressure (DBP) by 16.67% (p<0.001). Significant regression of left ventricular hypertrophy (LVH) was observed, as indicated by a 7.6% reduction in left ventricular mass index (LVMI) (p<0.001). Pulse wave velocity (PWV) decreased significantly from 9.95±2.13 m/s to 9.00±1.12 m/s (p=0.019). The lipid profile improved during therapy, with reductions in total cholesterol (p=0.009) and LDL cholesterol (p=0.018).
Conclusion. Six-month fixed-combination therapy with telmisartan/amlodipine demonstrated high antihypertensive efficacy, pronounced cardio-, vaso-, and nephroprotective effects, as well as a favorable impact on the metabolic profile in patients with AH, establishing it as a combination of choice, particularly in the presence of cardiometabolic risk factors.
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List of references
-
World Health Organization. Hypertension. WHO Fact Sheet. 2024. Available at: https://www.who.int/ news-room/fact-sheets/detail/hypertension.
-
World Health Organization Uzbekistan Health data overview for the Republic of Uzbekistan.https://data.who.int/countries/860.
-
Kario K, Okura A, Hoshide S, et al. The WHO Global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertens Res. 2024;47(5):1099-1102. https://doi.org/10.1038/s41440-024-01622-w.
-
McEvoy JW, McCarthy C, Bruno JG, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912-4018. https://doi.org/10.1093/eurheartj/ehae1 78.
-
Rodgers A, Salam A, Schutte AE, et al. Efficacy and safety of a novel low-dose triple single-pill combination of telmisartan, amlodipine and indapamide, compared with dual combinations for treatment of hypertension: a randomised, double-blind, active-controlled, international clinical trial. Lancet. 2024;404(10462):1536-1546. https://doi.org/10.1016/S0140-6736(24)01744-6.
-
Elbardisy S, Alotaibi MN, Saad AR, et al. Single-Pill Combination Therapy of Amlodipine, Telmisartan, and Chlorthalidone in the Management of Hypertension: A Systematic Review of Randomized Controlled Trials. Cureus. 2024;16(9):e68802. https://doi.org/10.7759/cureus.68802.
-
Morawietz H, Bornstein SR. Effects of telmisartan on metabolic syndrome components: a comprehensive review. Biomed Pharmacother. 2024;170:115996. https://doi.org/10.1016/j.biopha.2023.115996.
-
The ONTARGET Investigators Telmisartan, Ramipril Both in Patients at High Risk Vascular Events N Engl О Med 2008;358:1547-1559.
-
Cho EJ, Kim MH, Kim YH, et al. Efficacy and safety of standard dose triple combination of telmisartan 80 mg/amlodipine 5 mg/chlorthalidone 25 mg in primary hypertension: A randomized, double-blind, active-controlled, multicenter phase 3 trial. J Clin Hypertens (Greenwich). 2023;25(9):817-827. https://doi.org/10.1111/jch.14707.
-
Sung KC, Sung JH, Cho EJ, et al. Efficacy and safety of low-dose antihypertensive combination of amlodipine, telmisartan, and chlorthalidone: A randomized, double-blind, parallel, phase II trial. J Clin Hypertens (Greenwich). 2022;24(10):1298-1309. https://doi.org/10.1111/jch.14570.
-
Kim HM, Hwang IC, Choi HM, et al. Prognostic implication of left ventricular hypertrophy regression after antihypertensive therapy in patients with hypertension. Front Cardiovasc Med. 2022;9:1082008. https://doi.org/10.3389/fcvm.2022.1082008.
-
Martin TG, Juarros MA, Leinwand LA. Regression of cardiac hypertrophy in health and disease: mechanisms and therapeutic potential. Nat Rev Cardiol. 2023;20(5):347-363. https://doi.org/10.1038/s4 1569-022-00806-6.
-
Kawasoe S, Ohishi M. Regression of left ventricular hypertrophy. Hypertens Res. 2024;47(3):627-639. https://doi.org/10.1038/s41440-024-01634-6.
-
Spronck B, Terentes-Printzios D, Avolio AP, et al. 2024 Recommendations for Validation of Noninvasive Arterial Pulse Wave Velocity Measurement Devices. Hypertension. 2024;81(1):183-192. https://doi.org/10.1161/HYPERTENSIONAHA.123.21618.
-
An DW, Hansen TW, Aparicio LS, et al. Derivation of an Outcome-Driven Threshold for Aortic Pulse Wave Velocity: An Individual-Participant Meta-Analysis. Hypertension. 2023;80(12):1949-1959. https://doi.org/10.1161/HYPERTENSIONAHA.123.21318.
-
Vasan RS, Pan S, Xanthakis V, et al. Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study. Hypertension. 2022;79(5):1045-1056. https://doi.org/10.1161/HYPERTENSIONAHA.121.18776.
-
Park S, Hwang D, Kang J, et al. Efficacy and Safety of Triple Therapy of Telmisartan/Amlodipine/Rosuvastatin in Patients with Dyslipidemia and Hypertension: A Multicenter Randomized Clinical Trial. Curr Ther Res Clin Exp. 2024;100:100735. https://doi.org/10.1016/j.curtheres. 2024.100735.
-
Habboush S, Kagita NV, Gadelmawla AF, et al. Triple Therapy With Telmisartan, Amlodipine, and Rosuvastatin (TAR) Versus Telmisartan/Amlodipine (TA) and Telmisartan/Rosuvastatin (TR) Combinations in Hypertension and Dyslipidemia: A Systematic Review and Meta-Analysis. High Blood Press Cardiovasc Prev. 2024;32(1):49-60. https://doi.org/10.1007/s40292-024-00689-3.
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