{"id":"4998002595a5","type":"article","url":"https://hartvaat.nl/2026/10/09/telmisartan-chlorthalidon-fdc-verlaagt-bloeddruk-effectiever-dan-telmisartan-mon/","title":"Telmisartan-chlorthalidon FDC verlaagt bloeddruk effectiever dan telmisartan monotherapie","title_en":"Telmisartan-Chlorthalidone Fixed-Dose Combination at Two Chlorthalidone Dose Levels versus Telmisartan in Uncontrolled Hypertension: A Phase III Trial.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"American journal of hypertension","doi":"10.1093/ajh/hpag081","source_url":"https://doi.org/10.1093/ajh/hpag081","authors":["Seung-Whan Lee","Jin-Man Cho","Soon Jun Hong","Seung Hwan Han","Gyu Chul Oh","Seong Hwan Kim","Jung-Hoon Sung","Sang-Rok Lee","Gyung-Min Park","Hyun-Jae Kang","Jun-Hee Lee","Ji-Yong Choi","Kyung Hee Lim","Cheol Ung Choi","Byeong-Keuk Kim","Sang-Hyun Kim","In-Ho Chae"],"significance":5,"published":"2026-10-17","source_date":"2026-10-09","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/obstructief-slaapapneu-en-hart/","https://hartvaat.nl/kennis/farmacologie/antiaritmica-farmacologie/"],"congress":"","summary_en":"In a phase III randomized trial (n=254), patients with uncontrolled hypertension on telmisartan monotherapy were assigned to telmisartan/chlorthalidone fixed-dose combinations (12.5 mg or 6.25 mg) or telmisartan 40 mg for 8 weeks. The FDCs produced significantly greater systolic blood pressure reductions (-9.5 mmHg and -6.1 mmHg, respectively) and higher rates of achieving blood pressure targets (53.2% and 43.0% versus 32.9%). Safety profiles were comparable across groups. These findings support the use of this ARB-thiazide FDC as a practical and effective next-step therapy for patients requiring additional blood pressure control.","created":"2026-10-10T01:34:05Z","updated":"2026-10-10T01:34:05Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een fase III-gerandomiseerde studie (n=254) werd bij patiënten met onvoldoende gecontroleerde bloeddruk onder telmisartan-monotherapie gekeken naar het effect van vaste combinaties met telmisartan/chlorthalidon (12,5 mg of 6,25 mg) versus telmisartan 40 mg gedurende 8 weken. De FDC's leidden tot een significante extra daling van de systolische bloeddruk (-9,5 mmHg en -6,1 mmHg respectievelijk) en een hogere kans op het behalen van de streefwaarde (<140/90 mmHg of <130/80 mmHg bij risicopatiënten: 53,2% en 43,0% versus 32,9%). Deze bevindingen ondersteunen de inzet van deze FDC als veilige en effectieve stap in de trapsgewijze behandeling van hypertensie, vooral bij patiënten die monotherapie niet goed verdragen of waar nodig zijn.","abstract_original":"BACKGROUND: Evidence comparing different diuretic doses within fixed-dose combinations (FDCs) remains limited. We evaluated telmisartan/chlorthalidone FDCs according to chlorthalidone dose in patients with blood pressure (BP) inadequately controlled on telmisartan monotherapy. METHODS: In this randomized, double-blind trial, 254 patients with uncontrolled BP [sitting systolic blood pressure (SBP) ≥140 and <180 mmHg; sitting diastolic blood pressure (DBP) <110 mmHg] after a telmisartan run-in period were randomized (1:1:1) to receive either telmisartan/chlorthalidone FDCs (40/12.5 or 40/6.25 mg), or telmisartan 40 mg for 8 weeks. The primary endpoint was the change in sitting SBP from baseline to Week 8. RESULTS: At Week 8, telmisartan/chlorthalidone FDCs demonstrated greater reductions in sitting SBP compared with telmisartan monotherapy: least-squares mean differences were -9.5 mmHg [95% CI, -13.5 to - 5.6] for the 40/12.5 mg and -6.1 mmHg [95% CI, -10.4 to - 1.9] for the 40/6.25 mg. BP control rates (target BP: SBP/DBP <140/90 mmHg, or < 130/80 mmHg in patients with albuminuric chronic kidney disease or established cardiovascular disease) at Week 8 also favored telmisartan/chlorthalidone FDCs over telmisartan monotherapy (53.2% for the 40/12.5 mg and 43.0% for the 40/6.25 mg versus 32.9% for telmisartan 40 mg). Safety profiles were comparable among treatment groups. CONCLUSIONS: In patients inadequately controlled on telmisartan alone, FDCs of telmisartan with two different doses of chlorthalidone provided greater BP reduction than telmisartan monotherapy without increased safety risk, supporting its role as an effective and well-tolerated treatment option."}