Comparative Effectiveness and Safety of Amlodipine and Telmisartan in Patients with Essential Hypertension: A Prospective Randomized Clinical Study
DOI:
https://doi.org/10.66021/pakmcr1599Keywords:
Essential Hypertension; Amlodipine; Telmisartan; Blood Pressure; Antihypertensive Therapy; Randomized Clinical Study; SafetyAbstract
Background: Essential hypertension is a significant public health issue worldwide and comparing the efficacy and safety of first-line antihypertensive drugs is relevant for optimizing treatment.
Objective: To compare the clinical effectiveness and safety of amlodipine and telmisartan in patients with essential hypertension by evaluating changes in systolic and diastolic blood pressure, achievement of target blood pressure, treatment response, and adverse drug reactions.
Methodology: The current study was a prospective, randomized, open-label, parallel-group, clinical study that was conducted from January to December of 2025. A total of 240 eligible patients were randomly assigned and treated with amlodipine (n=120) or telmisartan (n=120) for 12 weeks. Primary outcome was change in systolic and diastolic blood pressure, secondary outcomes were attaining target blood pressure, treatment response, adverse drug reactions, laboratory safety parameters and predictors of successful blood pressure control. The data collected was analyzed using SPSS version 27.0 at P<0.05.
Results: Baseline demographic and clinical characteristics were comparable between the two groups (p>0.05). After 12 weeks, telmisartan achieved significantly greater reductions in systolic blood pressure (28.40 ± 9.84 mmHg vs. 25.30 ± 10.21 mmHg; p=0.021) and diastolic blood pressure (18.92 ± 7.02 mmHg vs. 16.32 ± 7.14 mmHg; p=0.009) than amlodipine. Target blood pressure was achieved in 103 patients (85.83%) receiving telmisartan compared with 91 patients (75.83%) receiving amlodipine (p=0.048). An excellent treatment response was observed in 92 patients (76.67%) in the telmisartan group and 78 patients (65.00%) in the amlodipine group (p=0.048). Overall adverse drug reactions occurred in 28 patients (23.33%) receiving telmisartan and 31 patients (25.83%) receiving amlodipine (p=0.670), whereas peripheral edema was significantly more frequent with amlodipine (11.67% vs. 2.50%; p=0.006).
Conclusion: Both treatments were effective and well tolerated; however, telmisartan was superior in blood pressure control, achieving target blood pressure and fewer cases of peripheral edema than amlodipine and therefore is recommended as an effective first-line agent for essential hypertension.
