A NEW low-dose three-in-one pill to treat hypertension could transform the way high blood pressure is treated around the world.
A trial revealed that most patients – 70 per cent – reached blood pressure targets with the “triple pill”, compared to just over half receiving normal care.
Traditionally, patients begin treatment with one drug at a very low dose, which is increased over time with more drugs added and increased in dosage to try to reach target.
Researchers from the George Institute for Global Health tested an entirely new way of treating hypertension by giving patients three drugs, each at half dose, in a single pill for early treatment of high blood pressure.
The trial, conducted in Sri Lanka and reported in the Journal of the American Medical Association, enrolled 700 patients with an average age of 56 and blood pressure of 154/90 mm Hg.
Patients were randomly assigned to receive either the combination pill or usual care – their doctor’s choice of blood pressure-lowering medication. The triple pill consisted of the blood pressure medications telmisartan (20mg), amlodipine (2.5mg) and chlorthalidone (12.5mg).
Compared with patients receiving usual care, a significantly higher proportion of patients receiving the triple pill achieved their target blood pressure of 140/90 or less (with lower targets of 130/80 for patients with diabetes or chronic kidney disease).
Anushka Patel, principal investigator of the trial and chief scientist at the institute, said this was a big improvement.
“The World Heart Federation has set an ambitious goal that by 2025 there will be a 25 per cent reduction in blood pressure levels globally,” Professor Patel said.
“The triple pill could be a low cost-way of helping countries around the world to meet this target.”
With high blood pressure the leading cause of disease burden worldwide, it’s expected the findings will change guidelines globally.
The institute’s Ruth Webster said this was a major advance by showing that the triple pill was not only more effective than standard care, it was also safe.
“It's estimated more than a billion people globally suffer from high blood pressure with the vast majority having poorly controlled blood pressure,” Dr Webster said.
“Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke.”
The institute is now looking at strategies to maximise uptake of the study results.
This includes examining the acceptability of the triple pill approach to patients and their doctors.