Assessing the effectiveness of a combined drug regimen on ambulatory blood pressure monitoring in stage 2 hypertension
Abstract
Stage 2 hypertension poses a major cardiovascular threat in Uzbekistan, where monotherapy often fails to achieve 24-hour control. This study assessed the efficacy of a fixed-dose telmisartan 80 mg/amlodipine 10 mg combination using ambulatory blood pressure monitoring (ABPM) in treatment-naïve patients. In this prospective, single-center trial at Tashkent's Republican Specialized Scientific-Practical Medical Center of Cardiology (January 2024–June 2025), 100 adults (mean age 54 years, 58% male) with office BP ≥140/90 mmHg received once-daily therapy for 12 weeks, alongside lifestyle counseling. ABPM (Oscar 2) captured 24-hour, daytime, and nighttime pressures at baseline and endpoint. Primary outcome: change in 24-hour mean BP. Analyses used paired t-tests and chi-square (p<0.05), powered for 12 mmHg systolic reduction. Therapy yielded significant reductions as 24-hour BP fell by 19.6/12.3 mmHg (p<0.001), daytime 20.7/13.1 mmHg, nighttime 17.4/10.5 mmHg (all p<0.001). Normal dipping rose from 32% to 72% (p<0.001); 92% were systolic responders, 78% achieved <130/80 mmHg 24-hour targets. Office BP dropped 22.8/13.8 mmHg (p<0.001). Adverse events were mild (24%, mainly edema); labs remained stable. Adherence exceeded 87%. Telmisartan-amlodipine combination excels in stage 2 hypertension, delivering robust ABPM control and dipping restoration with excellent tolerability. These findings support its first-line use in Central Asian settings to bridge persistent management gaps.