TITLE:
A Real-World Observational Study on the Usage Pattern, Safety, and Effectiveness of Telmisartan (TeleshalTM) and Telmisartan plus Hydrochlorothiazide (TeleshalTM-H) in Hypertensive Patients in Ghana
AUTHORS:
Christian Kubuafor
KEYWORDS:
Telmisartan, Hydrochlorothiazide, Hypertension, Ghana, Real-World Evidence, Observational Study, Sub-Saharan Africa
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.16 No.9,
September
9,
2026
ABSTRACT: Background: Hypertension is among the leading drivers of cardiovascular morbidity and mortality in sub-Saharan Africa, with persistently low rates of detection, treatment, and control. Real-world data on the use of telmisartan-based regimens in Ghana remain limited. Objectives: To evaluate the drug-utilization pattern, blood pressure-lowering effectiveness, adherence, and safety of telmisartan monotherapy (TeleshalTM) and the fixed-dose combination of telmisartan plus hydrochlorothiazide (TeleshalTM -H) in routine Ghanaian clinical practice. Methods: A non-interventional, multicenter, prospective, observational study was conducted at 15 sites across Ghana. Adults aged ≥ 18 years with hypertension clinically suitable for telmisartan (TeleshalTM) or telmisartan/HCTZ (TeleshalTM-H) were followed over 24 weeks, with assessments at baseline, 3 months, and 6 months. Demographic, clinical, vital-sign, body-weight, adherence, and adverse-event data were collected, and treating physicians rated overall efficacy and safety on a four-point ordinal scale. Within-group changes were evaluated using paired t-tests, with two-sided P Results: A total of 375 evaluable patients were available for the demographic analysis—249 receiving telmisartan monotherapy (Telesh alTM) and 126 receiving telmisartan + HCTZ (TeleshalTM-H). Mean ages were 53.54 ± 12.69 and 56.05 ± 12.72 years, respectively, with female predominance in both arms (53.1% and 51.6%). The most prevalent modifiable risk factors were poor dietary habits (61.3%/59.5%), physical inactivity (46.7%/42.0%), and alcohol consumption (25.7%/19.8%); the most common comorbidities were dyslipidemia (39.5%/39.1%) and diabetes (27.1%/24.8%). Over 24 weeks, telmisartan monotherapy reduced mean systolic blood pressure from 161.62 ± 18.91 mmHg to 132.33 ± 16.16 mmHg (−18.12%; P Conclusion: Both telmisartan monotherapy (TeleshalTM) and the telmisartan/HCTZ fixed-dose combination (TeleshalTM-H) produced clinically meaningful and statistically significant reductions in systolic and diastolic blood pressure over 24 weeks in routine Ghanaian practice, with favourable tolerability and physician-rated efficacy and safety. These findings support broader use of telmisartan-based regimens as part of an integrated strategy to mitigate hypertension-related cardiovascular morbidity and mortality in Ghana.