Why Combine?

Addressing the Gap for Blood Pressure Control

Resistant Hypertension

Figure 1. Steps for evaluation of resistant hypertension.²

Figure 2. The 2024 guidelines releasaed by the European Society of Cardiology recommend low-dose double combination therapy as first line treatment.¹
^{FU, follow up; Class I, II etc; levels of evidence}

Telmisartan and Amlodipine

Figure 3. Telmisartan interactions with receptors induce a.) glucose-lowering activity and (b) anti-obesity activity.⁸

Figure 4. Using amlodipine with a RAS inhibitor lowers the risk of CV death and adverse events.¹⁰

Figure 5. Telmisartan plus amlodipine results in improved antihypertensive ability.¹¹
^{A5, amlodipine 5 mg; A10, amlodipine 10mg; T80/A5,}^{Telmisartan 80mg + amlodipine 5mg}

Figure 6. one of the first steps in managing resistant hypertension is the optimization of the 3-drug treatment regimen.²

Combination Therapy

Key Messages

1. Effective treatment of resistant hypertension requires identification of its etiology and treatment of the underlying cause.
2. Both pharmacologic and non-pharmacologic treatments are utilized in the treatment of resistant hypertension.
3. Optimization of resistant hypertension treatment by using single-pill combination therapy is critical in lowering BP levels.
4. BP level goals and a lowered risk of CV events can only be achieved through effective treatment.

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^{Abbreviations:}^{ACEi, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blockers; BP, blood pressure; CCB, calcium channel blockers; CV, cardiovascular; RAS, renin-angiotensin system}

^References:^{1. McEvoy JW, et al. Eur Heart J 2024;45:3912-4018. 2. Carey RM, et al. Hypertension 2018;72:e53-e90. 3. Williams B, et al. J Hypertens 2018;36:1953. 4. Unger T, et al. Hypertension 2020;75:1334-1357. 5. Ona DID, et al. J Clin Hypertens 2021;23:1637-1650. 6. Bakheit AHH, et al. Profiles Drug Subst Excip Relat Methodol 2015:40:371-429. 7. Kakuta H, et al. Int J Clin Pharmacol Res 2005;25:41-46. 8. Imenshahidi M, et al. Biomed Pharmacother 2024;171:116169. 9. Chaugai S, et al. J Cardiovasc Pharmacol Ther 2018;23:433-445. 10. Fares H, et al. Open Heart 2016;3:e000473. 11. Neldam S, Lang M. J Clin Hypertens 2009;11(Suppl s1):114. 12. National Clinical Guideline Centre (UK). Hypertension: The Clinical Management of Primary Hypertension in Adults. London, UK: Royal College of Physicians (UK); 2011.}

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