Efficacy and safety of telmisartan in combination with hydrochlo-rothiazide in patients with mild to moderate hypertension

Objective:To evaluate the efficacy and safety of adjunctive therapy of telmisartan with hydrochlorothiazide in patients with mild to moderate hypertension.Methods:After 2-week wash-out period,152 patients with mild to moderate essential hypertension were administered with telmisartan 40 mg alone for 4 weeks.At the end of the 4-week therapy,patients who had diastolic blood pressure＞90 mmHg were treated with the combination of tehnisartan 40 mg with hydrochlorothiazide 12.5 mg for addi- tional 8 weeks.The efficacy was evaluated by the clinic blood pressure (CBP),electrocardiogram (ECG),blood biochemical parameters,24 h-ambulatory blood pressure (ABPM),pulse wave velocity (PWV) and two-dimensional echocardiography at the end of 0W,4W and 12W.Results:Compared with the telmisartan alone,the patients with the combination therapy(91.67%)experienced significant reduc- tions of clinical systolic blood pressure (CSBP)and clinical diastolic blood pressure (CDBP)(P＜0.001),decreasing by 16.70/15.28 mmHg.The patients showed significant reductions of 24 h mean SBP and DBP by 8.41/6.21 mmHg,and 24 h pulse pressure (24 hPP) by 4.60 mmHg.The daytime, nighttime blood pressure and blood pressure load were all decreased markedly(P＜0.05).The SBP and DBPtrough/peak ratio (T/P) was 72.66% vs.76.21% at the endofthe 12W.At the end of 4W,the patients had the PWV decrease of(10.19±1.44) from(11.17±1.83) m·s~(-1) (P＜0.05) at the end of 4W and of(9.24±1.01)m·s~(-1)(P＜0.01 ) at the end of 12W.In addition,the patients significantly showed the increase of E/A ratio,the shortness of isovolumic relaxation time(IVRT),and reduction of left veutrieular mass index(LVMI) (P＜0.05) at the end of 4W,and further improvements of diastolic function and LVMI at the end of 12W (P＜0.01).The incidence of adverse events was 9.7%.Conclu- sions:Combination of telmisartan 40 mg with hydrochlorothlazide tablets 12.5 mg offered therapeutic op- tions in patients with mild to moderate hypertension who were non-responsive to telmisartan monotherapy.