Dual‐Targeted Therapy in Cardiometabolic Risk: A Meta‐Analysis of Telmisartan‐Based Combinations for Hypertension and Dyslipidemia

TL;DR

This study compares two telmisartan-based treatments for high blood pressure and high cholesterol, finding each better for specific outcomes.

Contribution

A meta-analysis comparing telmisartan combinations for hypertension and dyslipidemia, highlighting individualized treatment efficacy.

Findings

Telmisartan plus amlodipine reduces blood pressure more effectively at 4 and 8 weeks.

Telmisartan plus rosuvastatin significantly lowers LDL cholesterol at both time points.

Both combinations have similar safety profiles with no significant difference in adverse events.

Abstract

Hypertension often coexists with dyslipidemia, requiring combination therapy. Telmisartan, combined with amlodipine or rosuvastatin, targets these conditions. This meta‐analysis evaluates the efficacy and safety of these combinations in adults with hypertension and dyslipidemia.

A systematic search was conducted in Cochrane Central, MEDLINE/PubMed, ClinicalTrials.gov, and ScienceDirect (as of June 2024) for randomized controlled trials (RCTs) comparing telmisartan plus amlodipine versus telmisartan plus rosuvastatin in adults (≥ 18 years) with hypertension and dyslipidemia. A random‐effects model was used with RevMan 5.4.1. The risk of bias and heterogeneity were assessed with the Cochrane Risk of Bias Tool and the I² statistic.

Three RCTs involving 320 participants were included. At 4 weeks, telmisartan + amlodipine yielded greater sSBP (sitting Systolic Blood Pressure) reduction compared to telmisartan + rosuvastatin (MD = −10.93 mmHg; 95% CI: −19.02 to −2.83; p = 0.008; I² = 70%). sDBP (sitting Diastolic Blood Pressure) reductions were greater in the amlodipine group at 8 weeks (MD = −8.59 mmHg; 95% CI: −13.35 to −3.82; p = 0.0004; I² = 58%). Conversely, LDL‐C reduction was favored by telmisartan + rosuvastatin, with significant effects observed at both 4 weeks (MD = 85.98 mg/dL) and 8 weeks (MD = 79.75 mg/dL). TEAE incidence did not differ significantly (RR = 1.23; 95% CI: 0.75–2.04; p = 0.41; I² = 0%).

Telmisartan + amlodipine demonstrates superior antihypertensive efficacy, while telmisartan + rosuvastatin more effectively lowers LDL‐C. Safety profiles are comparable. Findings support the selection of a regimen based on individualized therapeutic goals.

Figures