Low dose ‘quad’ pill for hypertension
A ‘quad pill’ containing low doses of four blood pressure lowering agents could provide good control of blood pressure with a low side-effect profile.
Australian researchers trialled a pill containing irbesartan 37·5mg, amlodipine 1·25mg, hydrochlorothiazide 6·25mg, and atenolol 12·5mg – each at a quarter of their usual dosages.
All 18 participants achieved systolic and diastolic blood pressure less than 140/90mmHg whilst on the quadpill, compared with six of 18 on placebo (relative risk 3.01, 95% CI 1.54 to 5.89).
The difference in mean systolic blood pressure between quadpill and placebo was 22.4mmHg (95% CI 16.5 to 28.3). The difference in mean diastolic blood pressure between quadpill and placebo was 13.1mmHg (95% CI 8.9 to 17.3).
According to the authors: “The findings suggest that the benefits of quarter-dose therapy could be additive across classes and might confer a clinically important reduction in blood pressure.”
“Most patients with hypertension are treated with monotherapy, and control rates are poor because monotherapy only reduces blood pressure by around 9/5 mmHg on average. There is a pressing need for blood pressure-control strategies with improved efficacy and tolerability,” they concluded.