New PBS listed medication for high blood pressure

24 February 2009

High blood pressure is a significant risk factor for both heart and kidney disease in the general population. Results from a recent study showed that one in three Australians aged over 25 years of age had high blood pressure (BP≥140/90 mmHg) or were taking medications to lower their blood pressure.

Several key findings from the study include:

3.0% of adults develop high blood pressure every year
The incidence of high blood pressure increases with age. The risk of developing high blood pressure is 8.4% for those aged 65–74 years compared to 1.0% for those aged 25–34 years
Those at greatest risk for developing high blood pressure include people with diabetes and those who were overweight or obese.
For smokers, the risk of high blood pressure is greater in males than in females.

A new medication, Micardis Plus 80/25mg (telmisartan 80mg plus hydrochlorothiazide 25mg), will be available on the Pharmaceutical Benefits Scheme (PBS) from 1 March 2009. A listing on the PBS means that the cost of this medication will be partly subsidised by the government. Those with health care cards and pensioner concession cards receive further discounts.

Associate Professor John Amerena, Cardiologist at Geelong Hospital Melbourne said that the listing of Micardis Plus onto the PBS, "means that there is a new medication available that can be used to improve blood pressure control using a compound that is safe and well tolerated and lowers blood pressure effectively."

Recent studies have suggested that patients with high blood pressure, not adequately managed with other drugs to lower blood pressure (antihypertensives), may respond to Micardis Plus (telmisartan/hydrochlorothiazide). Micardis Plus (telmisartan/hydrochlorothiazide) does not appear to be associated with an increased risk of side effects; however, common side effects include fatigue, dizziness, diarrhoea, nausea and headache.

The long-term safety and efficacy of Micardis Plus (telmisartan/hydrochlorothiazide) has been studied both alone and with the addition of other antihypertensive medications. It appears that Micardis Plus (telmisartan/hydrochlorothiazide) provides long term blood pressure control when given alone or as part of a multi-antihypertensive therapy, and is well-tolerated by patients.

In the clinical trials, the proportion of patients who continued to take Micardis Plus (telmisartan/hydrochlorothiazide) regularly and at the scheduled dose was high (>97%). However outside of clinical trials, the number of patients with high blood pressure that continue to take their medication as directed by their doctor in the long term is often poor. It is of vital importance that people with hypertension take their medication as directed by their doctor.

Some strategies to help improve the number of patients taking their medication regularly and as directed include improved education on the importance of compliance, the use of drugs with fewer side effects, simple dosing schedules and combination products, which allows fewer individual medications.

If you are having difficulty taking your medications regularly, you should talk to your general practitioner or specialist.

References

Barr ELM, Magliano DJ, Zimmet PZ, Polkinhorne KR, Atkins RC, Dunstan DW, et al. AusDiab 2005: The Australian diabetes, obesity and lifestyle study. Tracking the accelerating epidemic: its causes and outcomes. Melbourne: International Diabetes Institute, 2006.
Micardis Plus Product Information. North Ryde, NSW: Boehringer Ingelheim Pty Ltd; 3 February 2009.
Neldam S, Edwards C. Results of increasing doses of hydrochlorothiazide in combination with an angiotensin receptor blocker in patients with uncontrolled hypertension. J Clin Hypertens (Greenwich). 2008; 10(8): 612-8.
Neldam S, Edwards C. Long-term, open-label evaluation of the safety and efficacy of telmisartan 80 mg/hydrochlorothiazide 25 mg fixed-dose combination alone or with other antihypertensive medication. Expert Opin Pharmacother. 2009; 10(3): 345-52.
Simons LA, Ortiz M, Calcino G. Persistence with antihypertensive medication: Australia-wide experience, 2004-2006. Med J Aust. 2008; 188(4): 224-7.
Yusuf S, Teo KK, Pogue J, Dyal L, Copland I, Schumacher H, et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008; 358(15): 1547-59.