Evidence-based positioning of FDC of Telmisartan + Metoprolol + Chlorthalidone in cardiovascular space: Telmisartan is a universal anti-hypertensive agent with cardio-renal protection and eumetabolic effects. Metoprolol has compelling indications like post-MI, HRrEF, stable angina, complex CAD, AF and HCM Chlorthalidone is recommended as a preferred antihypertensive therapy over short-acting diuretics and is especially useful in the prevention of stroke and heart failure in hypertensive patients with multiple comorbidities. Reasons for multi-agent fixed-dose combination (FDC) Acute events in every vascular tree are unique. Different antihypertensive drugs are needed for different purposes. Beta-blockers are needed in case of complex CAD or in myocardial infarction. Chlorthalidone or other diuretics may be needed in recurrence of stroke or chances of heart failure. Most trials have used combination drugs for better control of hypertension. There may be reasons for specific drug combinations. Hypertension is a syndrome of comorbidities Lowering blood pressure (BP) matters most It matters a bit more how to lower BP in certain circumstances, e.g., complex CAD, MI, HFrEF, post-STEMI patients, renal disorder patients, or patients with prior stroke. Hypertension – Need of the Hour! Winning combinations based upon the risk profile and vascular tree involved. Telmisartan + Metoprolol + Chlorthalidone is a winning combination! In patients with CAD Beta blockers are required with RAS agents to counteract adverse pathophysiological changes. Relative risk estimates of coronary heart disease events in single drug blood pressure difference trials according to the drug [(beta) blockers or other), presence of CHD, and for (beta) blockers according to acute myocardial infarction on entry.] Drug-Placebo Comparison When the drug is compared with placebo as an antihypertensive drug and is assessed for new-onset heart failure, the best drugs are diuretics, ACEI and beta-blockers. Diuretics should be given in this combination especially in patients at high risk of developing heart failure.…
An antihypertensive FDC of Telmisartan + Metoprolol + ChlorthalidoneNovember 12, 2021 | 1 Comment
Dr. J C Mohan
Consultant Emeritus, Fortis Hospital, Shalimar Bagh, New Delhi
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