“Recent hypertension treatment guidelines clearly prioritize dual-drug combination therapy—especially low-dose fixed-dose combinations—right from the beginning. Telminuvo is the most logical and effective choice, fully aligning with proven prescribing principles and offering an unmatched solution for initial hypertension management.”

Professor Kim Dae-hee of Asan Medical Center’s Cardiology Department spoke at Chong Kun Dang’s press conference last Friday, marking the launch of Telminuvo (telmisartan/amlodipine). He outlined Telminuvo’s clinical value and recent insights into hypertension treatment.

Professor Kim said hypertension guidelines now prioritize low-dose dual therapy from the start. He noted that international guidelines all support lowering blood pressure more aggressively and quickly.

He specifically pointed out that the 2015 SPRINT study, which showed a roughly 25 percent reduction in major cardiovascular events and a 27 percent decrease in mortality in the group intensively controlled to below 130 mmHg systolic blood pressure, marked a turning point in global guideline changes.

The recent 2024 ESC guidelines recommend starting with a low-dose dual-drug combination for first-line treatment and expanding to a low-dose triple-drug if needed, Kim said. This shifts away from single-drug initiation to a new default: low-dose dual-drug therapy.

Compliance plummets with more pills, while SPCs solve this with ‘1 pill’

However, Professor Kim warned that low medication adherence is a major obstacle in multidrug therapy. He stressed that as the number of medications rises, patient compliance drops sharply, increasing the risk of failing to control blood pressure—making a strong case for efficient solutions.

Kim said, “When patients take three to five pills, they miss doses more often.” He explained that one study found adherence dropped over 70 percent when patients had to take five drugs instead of three.

Kim stressed that low-dose single-pill combinations (SPCs) address this practical adherence problem.

“Multiple meta-analyses have confirmed that SPCs can effectively lower blood pressure by targeting different mechanisms in one pill. By reducing the pill burden, SPCs like Telminuvo lead to higher medication adherence and make hypertension management simpler and more effective.”

ARB+CCB: What about the telmisartan–S-amlodipine combination?

Professor Kim asserted that ARB+CCB combinations dominate over 70 percent of dual-drug therapy prescriptions in Korea, explaining, “These two agents deliver complementary effects, overcoming each other's weaknesses and forming the most synergistic combination available.”

Kim explained the popularity of ARB+CCB combinations. "ARBs block the RAAS, providing protection for the heart. CCBs lower blood pressure well but may cause edema, and ARBs relieve this by dilating veins," he said.

When selecting an ARB, Kim cited telmisartan's long half-life and robust evidence base.

He stated, “Telmisartan allows 24-hour blood pressure control with once-daily dosing and has demonstrated cardiovascular risk reduction in large-scale trials. Its partial PPAR-γ agonism benefits metabolism, and its low renal excretion reduces the need for dose adjustment, which is especially helpful for patients with impaired kidney function.”

He said, “S-amlodipine uses only the active part of racemic amlodipine. It cuts the dose in half but maintains its blood pressure-lowering effect. It also reduces side effects like edema.”

Professor Kim stated, “Telmisartan is good for once-daily dosing due to its long half-life and high T/P ratio. S-amlodipine is also long-acting.” He added, “Telminuvo 20/1.25mg combines these two components at low doses and matches the latest trends: low-dose start, once-daily dosing, and early combination treatment.”

He added, “With low-dose dual therapy setting the new gold standard in hypertension care, practical tools are essential for real-world success. Telminuvo stands out as one of the most exemplary and forward-thinking options for clinicians today.”