Evidence map›Paper›PMID 41222871›Full record

SynthesisHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2026

Low-Dose Triple-Pill of Telmisartan, Amlodipine, and Indapamide for Initial Hypertension Treatment: A GRADE-Assessed Meta-analysis of Randomized Trials.

Abdalhakim Shubietah, Mohamed S Elgendy, Ahmed Emara, Hamza A Abdul-Hafez, Ameer Awashra, Ibrahim Elbably, Mohamed Abuelazm, Mohammed Mhanna

Abstract readMeta-AnalysisSystematic ReviewReview
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In one paragraph

Synthesis in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Renal Denervation in Cardiovascular Diseases: Mechanisms, Evidence, and Expanding Applications.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Abdalhakim ShubietahDepartment of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.ORCID http://orcid.org/0000-0002-8300-0262
Mohamed S ElgendyFaculty of Medicine, Tanta University, Tanta, Gharbia, Egypt. dr.elgendy.mo@gmail.com.ORCID http://orcid.org/0000-0003-3080-2875
Ahmed EmaraFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID http://orcid.org/0009-0001-2718-8627
Hamza A Abdul-HafezDepartment of Medicine, An-Najah National University, Nablus, West Bank, Palestine.ORCID http://orcid.org/0009-0003-6089-240X
Ameer AwashraDepartment of Medicine, An-Najah National University, Nablus, West Bank, Palestine.ORCID http://orcid.org/0009-0002-5122-8200
Ibrahim ElbablyFaculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.ORCID http://orcid.org/0009-0007-7262-409X
Mohamed AbuelazmFaculty of Medicine, Tanta University, Tanta, Gharbia, Egypt.ORCID http://orcid.org/0000-0002-2514-0689
Mohammed MhannaDivision of Cardiovascular Medicine, University of Iowa, Iowa, IA, USA.ORCID http://orcid.org/0000-0003-1443-7177

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFDA-approved GMRx2, a single-pill combination of telmisartan, amlodipine, and indapamide, has shown potential for improving blood pressure (BP) control.

aimWe assessed the efficacy and safety of low-dose GMRx2 compared to placebo, or standard-care (monotherapy or dual therapy) in mild to moderate hypertension.

methodsA meta-analysis of randomized controlled trials (RCTs) was conducted from PubMed, Embase, Cochrane, Scopus, and Web of Science from 2006 to June 2025. Random-effects model to pool mean difference (MD) for continuous outcomes and risk ratios (RR) for binary outcomes with 95% confidence intervals (CI). PROSPERO-ID: CRD420251108645

resultsFour RCTs involving 1999 patients were included. Compared with control, low-dose GMRx2 significantly reduced office systolic BP at 4-6 weeks (MD -8.84 mmHg, 95% CI [-11.27; -6.46]) and 12 weeks (MD -5.52 mmHg, 95% CI [-6.85; -4.18]). It also increased the proportion of patients achieving target office BP at 4-6 weeks (66.7% vs. 50.2%, RR 1.20, 95% CI [1.08-1.43]) and 8-12 weeks (75.6% vs. 59.5%, RR 1.15, 95% CI [1.05-1.26]). No significant differences were observed in serious adverse events (P= 0.77) or treatment discontinuation (P= 0.30). However, low-dose GMRx2 had a higher incidence of hypokalemia (9% vs. 7%, RR 1.40, 95% CI [1.04-1.90]) and hyponatremia (5% vs. 3.7%, RR 1.59, 95% CI [1.04-2.42]).

conclusionLow-dose GMRx2 provides superior BP reduction and a well-tolerated safety profile in patients with mild to moderate hypertension. Nonetheless, it may increase the risk of hypokalemia and hyponatremia. Larger and longer-term RCTs are warranted to confirm.

Indexed as

AmlodipineAngiotensin II Type 1 Receptor BlockersAntihypertensive AgentsBlood PressureCalcium Channel BlockersHypertensionIndapamideTelmisartanAdultAgedDrug CombinationsFemaleHumansMaleMiddle AgedRandomized Controlled Trials as TopicAmlodipineAngiotensin II Type 1 Receptor BlockersAntihypertensive AgentsCalcium Channel BlockersDrug CombinationsIndapamideTelmisartantelmisartan amlodipine combinationBlood pressureHypertensionInitial treatmentLow-dose single-pillMeta-analysisTriple antihypertensive drugs

Identifiers

PMID41222871

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.