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Telmisartan 80mg Plus Hydrochlorothiazide 25mg First Line in Moderate or Severe Hypertension

A Randomised, Double-blind, Double Dummy, Active Controlled, Parallel Group, Forced Titration Study to Compare the Fixed-dose Combination of Telmisartan 80mg Plus Hydrochlorothiazide 25mg (T80/HCTZ25) Versus Telmisartan 80mg (T80) Monotherapy as First Line Therapy in Patients With Grade 2 or Grade 3 Hypertension (Systolic Blood Pressure (SBP) >=160 mmHg and Diastolic Blood Pressure (DBP) >=100 mmHg)

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00926289
Enrollment
894
Registered
2009-06-23
Start date
2009-06-30
Completion date
Unknown
Last updated
2014-06-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hypertension

Brief summary

The primary objective of this trial is to demonstrate that the fixed-dose combination of T80/HCTZ25 is superior as first line therapy in reducing seated trough cuff Systolic Blood Pressure(SBP) compared to the monotherapy of T80 in patients with grade 2 or grade 3 hypertension (SBP\>=160 mmHg and Diastolic Blood Pressure(DBP)\>=100 mmHg).

Interventions

DRUGTelmisartan

Telmisartan 80mg

DRUGHydrochlorothiazide

Hydrochlorothiazide25mg

Sponsors

Boehringer Ingelheim
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Ability to provide written informed consent in accordance with Good Clinical Practice and local legislation; 2. Age 18 years or older; 3. Patients with grade 2 or grade 3 hypertension as defined SBP\>=160 mmHg and DBP\>=100 mmHg at randomization 4. Ability to stop any current antihypertensive therapy without unacceptable risk to the patient (Investigator's discretion)

Exclusion criteria

1. Pre-menopausal women (last menstruation \<=1 year prior to signing informed consent) who: a) are not surgically sterile; or b) are nursing, or c) are pregnant, or d) are of childbearing potential and are NOT practicing acceptable methods of birth control, or do NOT plan to continue practicing an acceptable method throughout the trial. The only acceptable methods of birth control are: Intra-Uterine Device (IUD), Oral contraceptives, Implantable or injectable contraceptives, Estrogen patch Hormonal birth control should have been in use for at least three months before the study and continue at least until the next menstrual period after completing the study. 2. Night shift workers who routinely sleep during the daytime and whose work hours include midnight to 4:00 a.m. 3. Known or suspected secondary hypertension (e.g., renal artery stenosis orphaeochromocytoma) 4. Mean in-clinic seated cuff SBP\>= 200 mmHg and/or DBP \>=120 mmHg 5. Renal dysfunction as defined by the following laboratory parameters: Serum creatinine \>3.0 mg/dL (or \>265 umol/L) and/or known creatinine clearance of \<30 ml/min and/or clinical markers of severe renal impairment. 6. Bilateral renal artery stenosis, renal artery stenosis in a solitary kidney, post-renal transplant patients or patients with only one kidney 7. Clinically relevant hypokalemia or hyperkalemia (i.e., \<3.5 mmol/L or \>5.5 mmol/L, may be rechecked for suspected error in result) 8. Uncorrected sodium or volume depletion 9. Primary aldosteronism. 10. Hereditary fructose intolerance 11. Biliary obstructive disorders (e.g., cholestasis) or hepatic insufficiency 12. Congestive heart failure New York Heart Association functional class Congestive Heart Failure III-IV (Refer to Appendix 10.3) 13. Contra-indication to a placebo run-in period (e.g., stroke with-in the past 6 months, myocardial infarction, cardiac surgery, percutaneous transluminal coronary angioplasty, unstable angina or coronary artery bypass graft within the past 3 months prior to start of run in period) 14. Clinically significant ventricular tachycardia, atrial fibrillation, atrial flutter or other clinically relevant cardiac arrhythmias as determined by the Investigator 15. Hypertrophic obstructive cardiomyopathy, severe obstructive coronary artery disease, aortic stenosis, hemodynamically relevant stenosis of the aortic or mitral valve 16. Patients whose diabetes has not been stable and controlled for at least the past 3 months as defined by an Glycosylated Hemoglobin \>=10% 17. Patients who have previously experienced symptoms characteristic of angioedema during treatment with ACE inhibitors or angiotensin-II receptor antagonists 18. History of drug or alcohol dependency within 6 months prior to signing the informed consent form 19. Concomitant administration of any medications known to affect blood pressure, except medications allowed by the protocol 20. Any investigational drug therapy within 1 month of signing the informed consent 21. Known hypersensitivity to any component of the trial drugs (telmisartan, hydrochlorothiazide, or placebo) 22. History of non-compliance or inability to comply with prescribed medications or protocol procedures (less than 80% or more than 120%, especially during run-in) 23. Any other clinical condition which, in the opinion of the investigator, would not allow safe completion of the protocol and safe administration of the trial medication

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Mean Seated Trough Cuff Systolic Blood Pressure (SBP) to Week 7Baseline and Week 7The SBP value at baseline was subtracted from the SBP value at Week 7.

Secondary

MeasureTime frameDescription
Change From Baseline in Mean Seated Trough Cuff SBP to Week 3Baseline and Week 3The SBP value at baseline was subtracted from the SBP value at Week 3.
Change From Baseline in Mean Seated Trough Cuff Diastolic Blood Pressure (DBP) to Week 7Baseline and Week 7The DBP value at baseline was subtracted from the DBP value at Week 7.
Number of Patients With SBP Control (SBP < 140 mmHg) at Week 7Week 7 timepointSBP control is defined as SBP \< 140 mmHg.
Number of Patients With SBP Control (SBP < 140 mmHg) at Week 5Week 5 timepointSBP control is defined as SBP \< 140 mmHg
Number of Patients With SBP Control (SBP < 140 mmHg) at Week 3Week 3 timepointSBP control is defined as SBP \< 140 mmHg
Number of Patients With DBP Control (DBP < 90 mmHg) at Week 7Week 7 timepointDBP control is defined as DBP\<90 mmHg
Change From Baseline in Mean Seated Trough Cuff SBP to Week 5Baseline and Week 5The SBP value at baseline was subtracted from the SBP value at Week 5.
Number of Patients With DBP Control (DBP < 90 mmHg) at Week 3Week 3 timepointDBP control is defined as DBP\<90 mmHg
Number of Patients With Blood Pressure (BP) Control at Week 7Week 7 timepointBP control is defined as SBP\<140 mmHg and DBP \< 90 mmHg and is adjusted for baseline SBP
Number of Patients With BP Control at Week 7Week 7 timepointBP control is defined as SBP\<140 mmHg and DBP \< 90 mmHg and is adjusted for baseline DBP
Number of Patients With Systolic Blood Pressure (SBP) Response at Week 7Week 7 timepointSBP response is defined as SBP\<140 mmHg or a reduction of \>= 15 mmHg
Number of Participants With DBP Response at Week 7Week 7 timepointDBP response is defined as DBP\<90 mmHg or a reduction of \>= 10 mmHg
BP Categories at Week 7Week 7 timepointBP categories comprise: * BP optimal (SBP \<120 mmHg and DBP \<80 mmHg) * BP normal (SBP \<130 mmHg and DBP \<85 mmHg but not 'optimal') * BP high normal (SBP \<140 mmHg and DBP \<90 mmHg but not 'normal') * Grade 1 hypertension (SBP \<160 mmHg and DBP \<100 mmHg but not 'high normal') * Grade 2 hypertension (SBP \<180 mmHg and DBP \<110 mmHg but not 'Grade 1 hypertension') * Grade 3 hypertension (SBP ≥180 mmHg or DBP ≥110 mmHg)
Number of Patients With DBP Control (DBP < 90 mmHg) at Week 5Week 5 timepointDBP control is defined as DBP\<90 mmHg

Countries

Bulgaria, China, France, Georgia, Romania, Russia, South Korea, United States

Participant flow

Pre-assignment details

894 patients were entered (randomised) into the study; however, of these, 6 were not treated. Therefore 888 patients actually entered into treatment.

Participants by arm

ArmCount
Telmisartan 40/80 mg
Telmisartan 40mg once daily for 1 week with forced titration to 80 mg for 6 weeks
294
Telmisartan 40/80 mg + HCTZ 12.5/25 mg
fixed combination of Telmisartan 40mg and HCTZ 12.5 mg once daily for 1 week with forced titration to T80+HCTZ25 for 6 weeks
594
Total888

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event911
Overall StudyLost to Follow-up36
Overall StudyOther13
Overall StudyProtocol Violation812
Overall StudyWithdrawal by Subject44

Baseline characteristics

CharacteristicTelmisartan 40/80 mgTelmisartan 40/80 mg + HCTZ 12.5/25 mgTotal
Age, Continuous57.6 Years
STANDARD_DEVIATION 11.9
56.8 Years
STANDARD_DEVIATION 11.3
57.0 Years
STANDARD_DEVIATION 11.5
Sex: Female, Male
Female
125 Participants285 Participants410 Participants
Sex: Female, Male
Male
169 Participants309 Participants478 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
0 / 2940 / 594
serious
Total, serious adverse events
1 / 2940 / 594

Outcome results

Primary

Change From Baseline in Mean Seated Trough Cuff Systolic Blood Pressure (SBP) to Week 7

The SBP value at baseline was subtracted from the SBP value at Week 7.

Time frame: Baseline and Week 7

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Telmisartan 40/80 mgChange From Baseline in Mean Seated Trough Cuff Systolic Blood Pressure (SBP) to Week 7-28.5 mmHgStandard Error 0.88
Telmisartan 40/80 mg + HCTZ 12.5/25 mgChange From Baseline in Mean Seated Trough Cuff Systolic Blood Pressure (SBP) to Week 7-37.0 mmHgStandard Error 0.62
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [-10.6, -6.4]ANCOVA
Secondary

BP Categories at Week 7

BP categories comprise: * BP optimal (SBP \<120 mmHg and DBP \<80 mmHg) * BP normal (SBP \<130 mmHg and DBP \<85 mmHg but not 'optimal') * BP high normal (SBP \<140 mmHg and DBP \<90 mmHg but not 'normal') * Grade 1 hypertension (SBP \<160 mmHg and DBP \<100 mmHg but not 'high normal') * Grade 2 hypertension (SBP \<180 mmHg and DBP \<110 mmHg but not 'Grade 1 hypertension') * Grade 3 hypertension (SBP ≥180 mmHg or DBP ≥110 mmHg)

Time frame: Week 7 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureGroupValue (NUMBER)
Telmisartan 40/80 mgBP Categories at Week 7Grade 2 hypertension44 Participants
Telmisartan 40/80 mgBP Categories at Week 7BP normal36 Participants
Telmisartan 40/80 mgBP Categories at Week 7BP optimal6 Participants
Telmisartan 40/80 mgBP Categories at Week 7Grade 1 hypertension120 Participants
Telmisartan 40/80 mgBP Categories at Week 7Grade 3 hypertension22 Participants
Telmisartan 40/80 mgBP Categories at Week 7BP high normal57 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgBP Categories at Week 7Grade 3 hypertension11 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgBP Categories at Week 7BP high normal138 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgBP Categories at Week 7Grade 1 hypertension186 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgBP Categories at Week 7Grade 2 hypertension58 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgBP Categories at Week 7BP normal136 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgBP Categories at Week 7BP optimal44 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.0001Van Elteren test stratified for country
Secondary

Change From Baseline in Mean Seated Trough Cuff Diastolic Blood Pressure (DBP) to Week 7

The DBP value at baseline was subtracted from the DBP value at Week 7.

Time frame: Baseline and Week 7

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Telmisartan 40/80 mgChange From Baseline in Mean Seated Trough Cuff Diastolic Blood Pressure (DBP) to Week 7-15.4 mmHgStandard Error 0.55
Telmisartan 40/80 mg + HCTZ 12.5/25 mgChange From Baseline in Mean Seated Trough Cuff Diastolic Blood Pressure (DBP) to Week 7-18.6 mmHgStandard Error 0.38
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [-4.5, -1.9]ANCOVA
Secondary

Change From Baseline in Mean Seated Trough Cuff SBP to Week 3

The SBP value at baseline was subtracted from the SBP value at Week 3.

Time frame: Baseline and Week 3

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Telmisartan 40/80 mgChange From Baseline in Mean Seated Trough Cuff SBP to Week 3-26.5 mmHgStandard Error 0.87
Telmisartan 40/80 mg + HCTZ 12.5/25 mgChange From Baseline in Mean Seated Trough Cuff SBP to Week 3-33.3 mmHgStandard Error 0.61
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [-8.8, -4.7]ANCOVA
Secondary

Change From Baseline in Mean Seated Trough Cuff SBP to Week 5

The SBP value at baseline was subtracted from the SBP value at Week 5.

Time frame: Baseline and Week 5

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Telmisartan 40/80 mgChange From Baseline in Mean Seated Trough Cuff SBP to Week 5-28.6 mmHgStandard Error 0.86
Telmisartan 40/80 mg + HCTZ 12.5/25 mgChange From Baseline in Mean Seated Trough Cuff SBP to Week 5-35.8 mmHgStandard Error 0.61
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [-9.3, -5.2]ANCOVA
Secondary

Number of Participants With DBP Response at Week 7

DBP response is defined as DBP\<90 mmHg or a reduction of \>= 10 mmHg

Time frame: Week 7 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Participants With DBP Response at Week 7202 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Participants With DBP Response at Week 7483 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.57, 3.16]Regression, Logistic
Secondary

Number of Patients With Blood Pressure (BP) Control at Week 7

BP control is defined as SBP\<140 mmHg and DBP \< 90 mmHg and is adjusted for baseline SBP

Time frame: Week 7 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With Blood Pressure (BP) Control at Week 799 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With Blood Pressure (BP) Control at Week 7318 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.76, 3.26]Regression, Logistic
Secondary

Number of Patients With BP Control at Week 7

BP control is defined as SBP\<140 mmHg and DBP \< 90 mmHg and is adjusted for baseline DBP

Time frame: Week 7 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With BP Control at Week 799 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With BP Control at Week 7318 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.78, 3.29]Regression, Logistic
Secondary

Number of Patients With DBP Control (DBP < 90 mmHg) at Week 3

DBP control is defined as DBP\<90 mmHg

Time frame: Week 3 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With DBP Control (DBP < 90 mmHg) at Week 3131 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With DBP Control (DBP < 90 mmHg) at Week 3343 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: 0.000595% CI: [1.28, 2.37]Regression, Logistic
Secondary

Number of Patients With DBP Control (DBP < 90 mmHg) at Week 5

DBP control is defined as DBP\<90 mmHg

Time frame: Week 5 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With DBP Control (DBP < 90 mmHg) at Week 5150 participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With DBP Control (DBP < 90 mmHg) at Week 5391 participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.48, 2.76]Regression, Logistic
Secondary

Number of Patients With DBP Control (DBP < 90 mmHg) at Week 7

DBP control is defined as DBP\<90 mmHg

Time frame: Week 7 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With DBP Control (DBP < 90 mmHg) at Week 7150 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With DBP Control (DBP < 90 mmHg) at Week 7389 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.46, 2.73]Regression, Logistic
Secondary

Number of Patients With SBP Control (SBP < 140 mmHg) at Week 3

SBP control is defined as SBP \< 140 mmHg

Time frame: Week 3 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With SBP Control (SBP < 140 mmHg) at Week 397 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With SBP Control (SBP < 140 mmHg) at Week 3306 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.6, 3.01]Regression, Logistic
Secondary

Number of Patients With SBP Control (SBP < 140 mmHg) at Week 5

SBP control is defined as SBP \< 140 mmHg

Time frame: Week 5 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With SBP Control (SBP < 140 mmHg) at Week 5119 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With SBP Control (SBP < 140 mmHg) at Week 5355 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.7, 3.12]Regression, Logistic
Secondary

Number of Patients With SBP Control (SBP < 140 mmHg) at Week 7

SBP control is defined as SBP \< 140 mmHg.

Time frame: Week 7 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With SBP Control (SBP < 140 mmHg) at Week 7122 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With SBP Control (SBP < 140 mmHg) at Week 7363 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.74, 3.21]Regression, Logistic
Secondary

Number of Patients With Systolic Blood Pressure (SBP) Response at Week 7

SBP response is defined as SBP\<140 mmHg or a reduction of \>= 15 mmHg

Time frame: Week 7 timepoint

Population: The Full Analysis Set (FAS) included all patients in the treated set who provide a baseline trough cuff BP measurement and at least one seated trough cuff BP measurement following titration to target therapy (T80+H25 or T80), taken on the same arm

ArmMeasureValue (NUMBER)
Telmisartan 40/80 mgNumber of Patients With Systolic Blood Pressure (SBP) Response at Week 7233 Participants
Telmisartan 40/80 mg + HCTZ 12.5/25 mgNumber of Patients With Systolic Blood Pressure (SBP) Response at Week 7527 Participants
Comparison: T80+HCTZ25 versus T80 monotherapyp-value: <0.000195% CI: [1.7, 4.04]Regression, Logistic

Source: ClinicalTrials.gov · Data processed: Mar 10, 2026