Neutel Joel M, Klein Christiane, Meinicke Thomas W, Schumacher Helmut
Orange County Heart Institute & Research Center, Orange, California, USA.
Blood Press. 2002;11(5):302-9. doi: 10.1080/080370502320779511.
This open-label, multicenter, extension study assessed the efficacy and tolerability of telmisartan 80 mg administered alone or with HCTZ and/or other antihypertensive agents over a maximal 1-year treatment period. Of the 690 patients with mild-to-moderate hypertension completing the preceding 6-week, randomized trial (comparing telmisartan 80 mg with losartan 50 mg/HCTZ 12.5 mg combination therapy), 489 patients (70.9%) continued in this extension study. A fixed-titration regimen was employed: all patients received telmisartan 80 mg initially, with the stepwise addition of HCTZ 12.5 mg, HCTZ 25 mg and/or other antihypertensives to attain diastolic blood pressure (DBP) control (<90 mmHg). At the final visit, DBP control was achieved in 70.0% (194/277) of patients maximally titrated to telmisartan 80 mg, 55.8% (48/86) titrated to telmisartan 80 mg + HCTZ 12.5 mg, 54.7% (47/86) titrated to telmisartan 80 mg + HCTZ 25 mg, and 64.7% (22/34) titrated to telmisartan 80 mg + other antihypertensive +/- HCTZ (12.5 or 25 mg). The DBP and systolic blood pressure (SBP) reductions observed in the preceding randomized trial continued during extension treatment. Progressively greater blood pressure reductions occurred with the sequential addition of HCTZ and other antihypertensives. Adding HCTZ 12.5 mg to telmisartan 80 mg was particularly effective at enhancing antihypertensive efficacy. All treatments were well tolerated. Thus, telmisartan 80 mg administered alone or with HCTZ (12.5 or 25 mg) and/or other antihypertensives maintains a clinically significant therapeutic effect over the long term in patients with mild-to-moderate hypertension.
这项开放标签、多中心的扩展研究评估了在最长1年的治疗期内，单独使用80毫克替米沙坦或与氢氯噻嗪及/或其他抗高血压药物联合使用的疗效和耐受性。在完成了之前为期6周的随机试验（比较80毫克替米沙坦与50毫克氯沙坦/12.5毫克氢氯噻嗪联合治疗）的690例轻至中度高血压患者中，489例患者（70.9%）继续参与了这项扩展研究。采用了固定滴定方案：所有患者最初均接受80毫克替米沙坦治疗，然后逐步添加12.5毫克氢氯噻嗪、25毫克氢氯噻嗪和/或其他抗高血压药物，以实现舒张压（DBP）控制（<90毫米汞柱）。在最后一次随访时，最大滴定至80毫克替米沙坦的患者中，70.0%（194/277）实现了DBP控制；滴定至80毫克替米沙坦+12.5毫克氢氯噻嗪的患者中，55.8%（48/86）实现了DBP控制；滴定至80毫克替米沙坦+25毫克氢氯噻嗪的患者中，54.7%（47/86）实现了DBP控制；滴定至80毫克替米沙坦+其他抗高血压药物+/-氢氯噻嗪（12.5或25毫克）的患者中，64.7%（22/34）实现了DBP控制。在之前的随机试验中观察到的DBP和收缩压（SBP）降低在扩展治疗期间持续存在。随着氢氯噻嗪和其他抗高血压药物的依次添加，血压降低幅度逐渐增大。在80毫克替米沙坦中添加12.5毫克氢氯噻嗪在增强抗高血压疗效方面特别有效。所有治疗的耐受性均良好。因此，单独使用80毫克替米沙坦或与氢氯噻嗪（12.5或25毫克）及/或其他抗高血压药物联合使用，对轻至中度高血压患者长期保持着具有临床意义的治疗效果。
