Expert Perspectives on the Clinical Use of Olmesartan + Calcium Channel Blockers + Diuretics Combination Therapy in the Management of Hypertension in Indian Settings

Abstract

Background: Although there are several studies available regarding the safety and effectiveness of olmesartan + calcium channel blockers (CCBs) + diuretics, there were dearth of studies among experts regarding the clinical use and prescription practices of olmesartan + calcium channel blockers (CCBs) + diuretics in Indian settings. Methods: This cross-sectional study utilized a 23-item, multiple-response questionnaire to gather expert opinions from specialists with expertise in BP and hypertension-related management. The survey comprised questions regarding guideline compliance, prevailing prescription practices, and experiences associated with the use of mono, dual, and triple combination treatments for managing uncontrolled BP and hypertension-related comorbidities. Results: Out of the 566 surveyed clinicians, around 50% adhered to the American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Almost 43% of the clinicians reported that 10-20% of patients require triple-drug antihypertensive combination therapy. Around 34% of the experts indicated that 21-30% of patients achieve a BP below 130/80 mm Hg with triple antihypertensive combination therapy. Nearly 46% reported that 21-30% of their patients exhibit comorbid dyslipidemia. Approximately 53% of the clinicians noted increased prevalence of proteinuria in patients aged 46-60 years, and about 76% stated that angiotensin receptor blockers (ARBs) are most frequently used as first-line antihypertensive drugs. Nearly 90% of the respondents suggested that olmesartan monotherapy provided superior BP reduction. Around 58% of the experts reported that in individuals with co-morbid diabetes, the most commonly prescribed combination was olmesartan + CCB. Conclusion: The survey highlighted clinician’s preference for the triple-drug combination therapy of olmesartan, CCBs, and diuretics, emphasizing its benefits in improving BP regulation and reducing hypertension-related complications. It also underscored the superior effectiveness of this combination over alternatives, noting advantages such as vasodilation and reductions in glucose and lipid levels.