Publication:

Management of hypertensive patients with ischemic heart disease and the role of a fixed-dose combination of telmisartan and metoprolol: a physician-based research survey

Background We aimed to understand the current practices of Indian practitioners in the management of hypertensive patients with ischemic heart disease.

Methods A quantitative, cross-sectional, questionnaire-based survey involving 145 cardiologists and consulting physicians who each saw 10 patients with hypertension and IHD in their clinical practice was conducted. The questionnaire consisted of 35 questions divided into three sections on prevalence and treatment of hypertension and IHD and role of fixed-dose combinations in therapy.

Results In all, 49.0% of physicians treated 25%-50% patients with hypertension and IHD in their routine practice, majority of whom were in the age group of 40-60 years regardless of gender. Telmisartan (97.0%) and metoprolol (86.0%) were the most preferred angiotensin receptor blocker (ARB) and beta-blocker, respectively, and 91.0% of physicians preferred a combination of metoprolol with telmisartan when monotherapy fails. In the opinion of the physicians, prevention of new cardiovascular events (63.0%) and improvement in quality of life (61.0%) were the leading benefits of telmisartan and metoprolol FDC, and all agreed that this FDC improves patient compliance and adherence to therapy. Furthermore, 97.0%, 90.0%, and 40.0% of physicians agreed/strongly agreed that the FDC could be prescribed to hypertensive patients with IHD, heart failure, and IHD and diabetes, respectively.

Conclusions In this pan-India survey, it was observed that FDCs of telmisartan and metoprolol could help in improving blood pressure, heart rate, patient compliance, and adherence to therapy. Nevertheless, large-scale, prospectively designed studies are warranted to validate these findings.