Glenmark Pharmaceuticals has introduced Telma AM Biso, a fixed-dose combination tablet containing telmisartan, amlodipine, and bisoprolol for treating uncontrolled hypertension with an raised heart rate and stable coronary artery disease (SCAD). The product launch coincides with World Heart Day on September 29, addressing a specific treatment gap in cardiovascular care where Indian patients face heightened risks due to distinct metabolic characteristics. Indian hypertensive patients frequently exhibit abdominal obesity, diabetes, dyslipidaemia, heightened sympathetic activity and amplified renin–angiotensin–aldosterone system activation, which together accelerate cardiovascular risk at a younger age.
This formulation meets an urgent clinical requirement. In India, 60% of newly diagnosed hypertensive patients exhibit signs of sympathetic overactivity, with an average resting heart rate of 82 beats per minute. Such raised rates place excessive demands on the heart, increasing myocardial workload and oxygen consumption. The combination works through three distinct pathways: bisoprolol, a beta-blocker, lowers heart rate; telmisartan, an angiotensin receptor blocker, reduces vascular resistance; and amlodipine, a calcium channel blocker, enhances vasodilation.
The tablet is available in two formulations: 40 mg telmisartan, 5 mg amlodipine, and either 2.5 mg or 5 mg bisoprolol. The inclusion of bisoprolol holds particular significance, as both Indian clinical guidelines and international research show its effectiveness in reducing cardiac stress. The BISOCAD study demonstrated that patients achieving a heart rate below 65 beats per minute through bisoprolol therapy faced a fourfold lower risk of adverse cardiovascular events compared with those maintaining rates between 70–74 beats per minute.
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Bisoprolol’s pronounced β1-selectivity also confers a predictable pharmacokinetic profile and favorable metabolic effects, making it suitable for patients who also have diabetes, dyslipidaemia or respiratory conditions. These findings align with the European Society of Hypertension’s 2023 guidelines, which specifically recommend beta-blockers for patients whose resting heart rates exceed 80 beats per minute.
Clinical research supports the effectiveness of each component. The TRANSCEND trial (2008) revealed that telmisartan lowered the combined risk of cardiovascular death, myocardial infarction, and stroke by 13% in high-risk patients who could not tolerate ACE inhibitors. Separate data from the CAMELOT study (2002) showed that amlodipine reduced cardiovascular events by 31% in individuals with coronary artery disease. While beta-
