Triple pill for blood pressure

A once-daily triple antihypertensive drug combination pill could help patients reach target blood pressures (BP).

In a study reported in JAMA (doi:10.1001/jama.2018.10359) therapy using the combination pill, which contains telmisartan 20mg, amlodipine 2.5mg and chlorthalidone 12.5mg, was compared to usual care in over 600 patients with mild to moderate hypertension.

The triple combination pill increased the proportion achieving target BP versus usual care at six months (70% versus 55%, 95% CI, 3.2% to 22.0%; p <0 .001). Mean systolic/diastolic BP at 6 months was 125/76mmHg for the triple combination pill versus 134/81mmHg for usual care. The combination pill was well tolerated, with 419 adverse events reported in 255 patients (38.1% for the combination pill versus 34.8% for usual care). There were no significant between-group differences in the proportion of patients withdrawing from BP-lowering therapy due to adverse events (6.6% for the combination pill versus 6.8% for usual care).

According to the authors, in mild to moderate hypertension, treatment with a pill containing low doses of three antihypertensive drugs led to an increased proportion of patients achieving their target BP goal versus usual care. Use of such medication as initial therapy or to replace monotherapy may be an effective way to improve BP control.

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