Telmisartan and amlodipine single-pill combinations vs amlodipine monotherapy for superior blood pressure lowering and improved tolerability in patients with uncontrolled hypertension: results of the TEAMSTA-5 study

Abstract

An 8-week, randomized, double-blind, controlled study with single-pill combinations of telmisartan 40 mg or 80 mg/amlodipine 5 mg (T40/A5 or T80/A5) vs monotherapy with amlodipine 5 mg or 10 mg (A10) in 1097 patients with uncontrolled hypertension (diastolic blood pressure [BP] ≥ 90 mm Hg). T40/A5 and T80/A5 resulted in significantly greater (P<.0001) reductions in seated trough systolic/diastolic BP vs A5 (-7.4 mm Hg/-3.6 mm Hg; -8.8 mm Hg/-4.9 mm Hg) and a significantly greater (P<.001) proportion of patients achieving systolic/diastolic BP goal rate (60.0%/56.7%; 65.7%/63.8%) vs A5 (39.2%/42.0%). Superior BP reductions were also seen with T40-T80/A5 vs A10, with BP goal rates at least as high as with A10; however, there was significantly more peripheral edema with A10 (27.2% vs 4.3% for pooled T40-T80/A5; P<.0001). Switching patients with uncontrolled BP to a single-pill combination of T40/A5 or T80/A5 is a better treatment option than up-titration to full-dose monotherapy with A10.

Figure 1

Patient disposition. A5 indicates amlodipine 5 mg; A10, amlodipine 10 mg; T40, telmisartan 40 mg; T80, telmisartan 80 mg.

Figure 2

Effect of 8 weeks of treatment with single‐pill combinations of telmisartan 40 mg/amlodipine 5 mg (T40/A5) or telmisartan 80 mg/amlodipine 5 mg (T80/A5) compared with monotherapy with A5 or amlodipine 10 mg (A10) on the change from baseline in seated trough systolic blood pressure (BP) (mm Hg) or diastolic BP (mm Hg).

Figure 3

Effect of 8 weeks of treatment with single‐pill combinations of telmisartan 40 mg/amlodipine 5 mg (T40/A5) or telmisartan 80 mg (T80)/A5 compared with monotherapy with A5 or amlodipine 10 mg (A10) on the proportion of patients who achieved blood pressure (BP) response (ie, systolic BP <140 mm Hg or systolic BP reduction ≥15 mm Hg; diastolic BP <90 mm Hg or diastolic BP reduction ≥10 mm Hg) (%).

Figure 4

Effect of 8 weeks of treatment with single‐pill combinations of telmisartan 40 mg/amlodipine 5 mg (T40/A5) or telmisartan 80 mg (T80)/A5 compared with monotherapy with A5 or amlodipine 10 mg (A10) on the proportion of patients with blood pressure (BP) goal (ie, systolic BP <140 mm Hg; diastolic BP <90 mm Hg; BP <140/90 mm Hg) (%).

Figure 5

Effect of 8 weeks of treatment with single‐pill combinations of telmisartan 40 mg/amlodipine 5 mg (T40/A5) or telmisartan 80 mg (T80)/A5 compared with monotherapy with A5 or amlodipine 10 mg (A10) on the proportion of patients on the rate of incidence of edema (%).