Telmisartan versus Amlodipine: A Comparative Clinical Study on Efficacy and Safety in Essential Hypertension
Keywords:
Amlodipine, Antihypertensive Therapy, Essential Hypertension, Efficacy, Safety, Telmisartan.Abstract
Background: Essential hypertension is a major cardiovascular risk factor in India, and both angiotensin II receptor blockers (ARBs) and dihydropyridine calcium channel blockers (CCBs) are widely used as first‑line agents. Telmisartan offers renin–angiotensin system blockade with partial peroxisome proliferator‑activated receptor‑gamma (PPAR‑γ) activity, while amlodipine reduces peripheral vascular resistance via L‑type calcium channel blockade.
Objectives: To compare the efficacy and tolerability of telmisartan and amlodipine in patients with mild to moderate essential hypertension.
Methods: A prospective, randomized, open‑label, parallel‑group study was conducted in 100 adults with mild to moderate essential hypertension over 12 weeks at SMIMS. Patients were randomized to telmisartan 40 mg once daily (Group T, n=50) or amlodipine 5 mg once daily (Group A, n=50). Clinic systolic and diastolic blood pressure (SBP, DBP) were recorded at baseline, 4, 8 and 12 weeks. Efficacy end points were mean change in SBP/DBP and proportion achieving target BP <140/90 mmHg. Tolerability was assessed by adverse drug reactions (ADRs) and withdrawals.
Results: Mean baseline BP was comparable between groups (telmisartan 152±8/96±6 mmHg; amlodipine 151±9/95±7 mmHg). At 12 weeks, both drugs significantly reduced SBP (telmisartan −20±9 mmHg; amlodipine −18±10 mmHg), with a modest numerical advantage for telmisartan. Telmisartan produced greater DBP reduction (−13±6 vs −10±7 mmHg) and a higher target BP achievement rate (78% vs 66%). Peripheral oedema occurred more frequently with amlodipine (16% vs 4%), whereas telmisartan was metabolically neutral or favourable for fasting glucose and lipid parameters.
Conclusion: Telmisartan and amlodipine are both effective in mild to moderate essential hypertension, but telmisartan showed superior diastolic BP reduction and better tolerability, particularly with respect to peripheral oedema and metabolic profile. Telmisartan may be preferred as initial monotherapy in hypertensive patients attending SMIMS, especially in those with metabolic risk factors.
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