title: Comparative study of high dose mono-therapy of amlodipine or telmisartan, and their low dose combination in mild to moderate hypertension.
abstract: BACKGROUND
  Hypertension is one of the major public health challenges worldwide. Angiotensin receptor blockers (ARBs) and Calcium channel blockers (CCBs) are among the first line antihypertensive drugs. However, optimal treatment strategies in mild to moderate hypertensives who failed to achieve blood pressure (BP) control with low-dose mono-therapy are not well established. This study was done to compare efficacy and safety of high dose mono-therapy of Amlodipine, Telmisartan and their low dose combination in mild to moderate hypertensives who failed to achieve BP control with low dose mono-therapy of either drug.
  
  
  METHODS
  A total of 96 patients, fulfilling inclusion and exclusion criteria were enrolled in the study after obtaining informed consent. Patients were randomized into three treatment groups i.e. Telmisartan 80 mg, Amlodipine 10 mg and low dose combination of Telmisartan 40 mg +Amlodipine 5 mg once daily for two months. The systolic BP, Diastolic BP, and ADRs were recorded at 0, 2, 4, 8 weeks.
  
  
  RESULTS
  In the present study, significant reduction of mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) was seen in all the three treatment groups. Low dose combination of Amlodipine 5 mg and Telmisartan 40 mg showed statistically significant reduction in SBP as compared to Telmisartan 80 mg mono-therapy and in DBP as compared to Amlodipine 10 mg mono-therapy. Maximum adverse drug reactions (ADRs) were reported in Amlodipine mono-therapy group, like ankle oedema, constipation, headache and fatigue.
  
  
  CONCLUSIONS
  In term of BP control, low-dose combination therapy appears a better therapeutic approach than high-dose mono-therapy.
authors.affiliation: Demonstrator, Department of Pharmacology, MG Medical College & Hospital , Jaipur, India .
authors.forename: Jaswant
authors.initials: J
authors.lastname: Goyal
authors.affiliation: Professor, Department of Pharmacology, MG Medical College & Hospital , Jaipur, India .
authors.forename: Zafer Yab
authors.initials: ZY
authors.lastname: Khan
authors.affiliation: Associate Professor, Department of Pharmacology, MG Medical College & Hospital , Jaipur, India .
authors.forename: Prerna
authors.initials: P
authors.lastname: Upadhyaya
authors.affiliation: Postgraduate Student, Department of Biochemistry, MG Medical College & Hospital , Jaipur, India .
authors.forename: Barkha
authors.initials: B
authors.lastname: Goyal
authors.affiliation: Assistant Professor, Department of Pharmacology, MG Medical College & Hospital , Jaipur, India .
authors.forename: Shipra
authors.initials: S
authors.lastname: Jain
keywords: Amlodipine; Hypertension; Low dose combination of telmisartan and amlodipine; Telmisartan