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"Triple pill" blood pressure combo proves more effective, safe than standard care

Published on 16/08/18 at 12:42pm

A “triple pill” combining three established and effective drugs at low dosage levels could prove much more effective in treating high blood pressure than any of its constituent elements alone, according to research conducted by the George Institute for Global Health, an independent medical institution with branches in the UK, Australia, and India.

“It's estimated more than a billion people globally suffer from high blood pressure, with the vast majority having poorly controlled blood pressure,” said lead study author Dr Ruth Webster, Head of Research Programs at the George Institute for Global Health in Australia. “Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke.”

Effective treatment usually requires complex multi-drug regimens, which increases the chance of adverse events and presents challenges to patients to adhere their medication on a daily basis. The triple pill combines three different classes of blood pressure drug, each already proven to be effective in treating the condition and lowering associated risk of death and illness: the angiotensin receptor blocker telmisartan, the calcium channel blocker amlodipine, and the antihypertensive/diuretic chlorthalidone.

The treatment was trialled in Sri Lanka in a study involving 700 patients with an average age of 56 years and an average blood pressure of 154/90 mm Hg, 58% of whom were female and 59% of whom were not receiving treatment for the condition prior to their enrolment. Additionally, 32% of the participants also had diabetes or chronic kidney disease.

After six months of treatment, a “significantly higher” proportion of those in the triple pill group achieved the study’s primary endpoint of a blood pressure target of 140/90 mm Hg or less – or 130/80 mm Hg or less in those with diabetes or chronic kidney disease. Those taking the triple pill saw a reduction in blood pressure of 8.7 mm Hg on average compared to just 4.5 mm Hg in those given standard of care.

“Most people – 70% – reached blood pressure targets with the Triple Pill. The benefits were seen straight away and maintained until six months, whereas with usual care control rates were 55% at six months and even lower earlier in the trial,” remarked Dr Webster. “Based on our findings, we conclude that this new method of using blood pressure-lowering drugs was more effective and just as safe as current approaches.”

Matt Fellows

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