Single-Pill Combination Therapy of Amlodipine, Telmisartan, and Chlorthalidone in the Management of Hypertension: A Systematic Review of Randomized Controlled Trials.

Autor:	Elbardisy S; Department of Cardiology, Saudi German Hospital, Dubai, ARE., Alotaibi MN; College of Medicine, Alfaisal University, Riyadh, SAU., Saad AR; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR., Alhatm M; College of Medicine, Alfaisal University, Riyadh, SAU., Alharbi OH; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR., Alyaqout FB; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR., Elshaer OE; College of Medicine, Alfaisal University, Riyadh, SAU., Alazmi AM; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR., Kagita NV; Department of Endocrinology, Thomas Jefferson University Hospital, Philadelphia, USA., Allam IM; Department of Medicine, Primary Health Care Corporation, Doha, QAT., Bhutta AI; College of Medicine, Fatima Memorial Hospital, Lahore, PAK., Habboush S; Department of Cardiology, Saudi German Hospital, Dubai, ARE., Sindi R; Faculty of Pharmacy, Umm Al-Qura University, Makkah, SAU., Aswad Y; College of Medicine, Alfaisal University, Riyadh, SAU., Alharran AM; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 06; Vol. 16 (9), pp. e68802. Date of Electronic Publication: 2024 Sep 06 (Print Publication: 2024).
DOI:	10.7759/cureus.68802
Abstrakt:	Hypertension is a major cause of cardiovascular disease and death worldwide. Low-dose combination therapy is a promising approach for managing hypertension due to its safety and efficacy. This systematic review evaluates the safety and efficacy of a single-pill, low-dose combination of amlodipine, telmisartan, and chlorthalidone for essential hypertension based on evidence from randomized controlled trials (RCTs). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched the Cochrane, Scopus, PubMed, and Web of Science databases until July 01, 2024, using the following search string: (telmisartan) AND (amlodipine) AND (chlorthalidone) AND (randomized OR randomly). The quality of the RCTs was assessed using the revised Cochrane risk of bias tool. The primary endpoint was the mean change in sitting systolic blood pressure (BP), with secondary endpoints including BP target achievement rates, BP response rates, and serious treatment-related adverse events. Overall, three RCTs met the inclusion criteria and exhibited a low risk of bias. The doses in the combination pill ranged from 2.5 to 5 mg of amlodipine, 20 to 80 mg of telmisartan, and 4.167 to 25 mg of chlorthalidone. Control groups varied, including usual care, amlodipine 10 mg, and dual therapy of telmisartan and amlodipine. Results showed significant reductions in mean sitting systolic and diastolic BP, improved BP control and response rates, and a generally safe profile with no significant differences in serious adverse events. Despite encouraging data, results should be interpreted with caution due to heterogeneity in doses and control groups. Further research should address the long-term effects and explore predictors of response to this therapy. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Elbardisy et al.)
Databáze:	MEDLINE
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