Rationality of the Fixed Dose Combination of Telmisartan and Amlodipine in Management of Mild to Moderate Hypertension Unresponsive to Low Dose Monotherapy

Abstract

Hypertension is a persistent medical condition which is specified by elevated blood pressure (BP) in the arteries. The aim of the therapy is to keep BP below 140/90 mmHg for most individuals, though certain studies recommend lesser target BP for those with diabetes or kidney disease. Monotherapy can effectively control BP in limited number of hypertensive patients and most patients require the combination of at least two drugs to achieve target BP. As BP is outcome of several physiological mechanisms, thus an attempt to block one (like monotherapy) tends to raise compensatory activity of others.Telmisartan is a potent, long-lasting, nonpeptide angiotensin II antagonist that acts on the angiotensin 1 (AT1) receptor subtype. Amlodipine, a third generation dihydropyridine calcium channel blocker (CCB), is illustrated by a higher vascular selectivity and a lesser negative inotropic effect compared to other CCBs. Many studies have reported that combination of Amlodipine and Telmisartan showed a statistically significant reduction in SBP and DBP as compared to Telmisartan monotherapy and in DBP as compared to Amlodipine monotherapy. The number of ADRs also is less in combination.The combination is also found to be more cost-effective. Thus, a combination of Amlodipine and Telmisartan is more rational than either of the monotherapy.