Dual-Targeted Therapy in Cardiometabolic Risk: A Meta-Analysis of Telmisartan-Based Combinations for Hypertension and...

Hypertension often coexists with dyslipidemia, requiring combination therapy. Telmisartan, combined with amlodipine or rosuvastatin, targets these conditions. This meta-analysis evaluates the efficacy and safety of these combinations in adults with hypertension and dyslipidemia.

A systematic search was conducted in Cochrane Central, MEDLINE/PubMed, ClinicalTrials.gov, and ScienceDirect (as of June 2024) for randomized controlled trials (RCTs) comparing telmisartan plus amlodipine versus telmisartan plus rosuvastatin in adults (≥ 18 years) with hypertension and dyslipidemia. A random-effects model was used with RevMan 5.4.1. The risk of bias and heterogeneity were assessed with the Cochrane Risk of Bias Tool and the I² statistic.

Three RCTs involving 320 participants were included. At 4 weeks, telmisartan + amlodipine yielded greater sSBP (sitting Systolic Blood Pressure) reduction compared to telmisartan + rosuvastatin (MD = -10.93 mmHg; 95% CI: -19.02 to -2.83; p = 0.008; I² = 70%). sDBP (sitting Diastolic Blood Pressure) reductions were greater in the amlodipine group at 8 weeks (MD = -8.59 mmHg; 95% CI: -13.35 to -3.82; p = 0.0004; I² = 58%). Conversely, LDL-C reduction was favored by telmisartan + rosuvastatin, with significant effects observed at both 4 weeks (MD = 85.98 mg/dL) and 8 weeks (MD = 79.75 mg/dL). TEAE incidence did not differ significantly (RR = 1.23; 95% CI: 0.75-2.04; p = 0.41; I² = 0%).

Telmisartan + amlodipine demonstrates superior antihypertensive efficacy, while telmisartan + rosuvastatin more effectively lowers LDL-C. Safety profiles are comparable. Findings support the selection of a regimen based on individualized therapeutic goals.