Comparative Effectiveness and Safety of Amlodipine, Telmisartan, and Chlorthalidone in Newly Diagnosed Hypertensive Indian Adults.

OBJECTIVE

Amlodipine, telmisartan, and chlorthalidone are the most prescribed antihypertensive drugs in the Indian population. In this study, we compared the effectiveness and safety of these drugs in newly diagnosed hypertensive adults.

METHODS

This was an open-label, prospective observational study in which we enrolled 99 newly diagnosed stage I hypertensive patients who were prescribed amlodipine (33 patients), telmisartan (33 patients), or chlorthalidone (33 patients) monotherapy. The primary endpoint was to compare the changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at days 15, 30, 45, 60, and 90 from baseline among the three treatment groups. Secondary endpoints include incidence of adverse drug reactions (ADRs); changes in body weight, blood glucose, and lipid profile; and kidney function test on day 90 compared to baseline.

RESULTS

All three groups showed a significant decrease in SBP and DBP on follow-up visits in comparison to baseline (p < 0.01), and the target BP was achieved by day 30. The incidence of ADRs was found to be lower in the telmisartan group (three) compared to the amlodipine group (five) and the chlorthalidone group (nine). The chlorthalidone group showed a significant increase in blood glucose and lipid levels (p < 0.05), whereas the telmisartan group showed a significant decrease in blood glucose and lipid levels (p < 0.05).

CONCLUSION

Telmisartan is more effective and safer as initial monotherapy followed by amlodipine than chlorthalidone.