Publication:

Optimizing hypertension care in the real world: a physician survey on telmisartan‑based combination therapy

Background Hypertension is a leading cause of global cardiovascular morbidity and mortality and most patients require combination therapy to achieve recommended blood pressure targets and reduce cardiovascular risk.

Methods This cross-sectional, questionnaire-based survey was conducted among 98 physicians attending a scientific meeting organized by the Cardiological society of India (CSI). The survey evaluated real-world hypertension management, including BP targets, use of combination therapy, preferred drug combinations and factors influencing telmisartan selection.

Results Most physicians reported frequent use of combination therapy at the time of treatment initiation, with 46% indicating its use in 20-40% of patients and 38% in 40-60% of patients. Blood pressure targets varied, with nearly half of respondents (48%) aiming for <130/80 mm Hg, while 30% targeted <140/90 mm Hg. Telmisartan plus amlodipine emerged as the most preferred first‑line combination (48%), followed by telmisartan plus chlorthalidone (31%). The telmisartan–amlodipine combination was commonly selected for patients with uncontrolled blood pressure (44%) and those presenting with stage 2 hypertension (41%). Triple therapy with telmisartan, cilnidipine, and chlorthalidone was predominantly reserved for resistant hypertension (57%). Regression of left ventricular hypertrophy (31%) and the presence of microalbuminuria (29%) were key factors influencing preference for telmisartan.

Conclusions The survey highlights a growing preference among clinicians for early combination therapy, intensive BP targets and therapies providing sustained 24-hour BP control. Telmisartan-based combinations were widely preferred, reflecting their complementary mechanisms and cardio-renal protective benefits. These findings suggest increasing adoption of guideline-directed strategies in real-world hypertension management.