22 March 2018

Is this new ‘triple pill’ the answer to high blood pressure?

The triple pill approach is an opportunity to 'leapfrog' over traditional approaches to blood pressure control.

Traditionally high blood pressure is treated with one of four main types of medicine: ACE inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers or thiazide diuretics.

Researchers now, however, report that a pill that combines three blood pressure-lowering drugs improves people's chances of lowering their high blood pressure. 

The pill contains low doses of the three medications – telmisartan, amlodipine and chlorthalidone.

The finding stems from a study of 700 people, who averaged 56 years old. All had high blood pressure.

More effective and just as safe

Among those who took the so-called "triple pill" for six months, 70% had achieved their blood pressure targets, compared with 55% of those who received their usual care. Usual care meant taking whatever blood pressure medicine their doctor prescribed.

The rate of side effects was no greater among those who took the three-in-one pill than among the usual care group.

"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," lead author Ruth Webster said in a news release from the American College of Cardiology. She's a researcher with the George Institute for Global Health at the University of New South Wales in Sydney, Australia.

Reconsideration of recommendations

"The most urgent need for innovative strategies to control blood pressure is in low- and middle-income countries," Webster said. "The triple pill approach is an opportunity to 'leapfrog' over traditional approaches to care and adopt an innovative approach that has been shown to be effective."

High blood pressure increases the risk for heart attack, stroke and kidney problems.

"A control rate of 70% would be a considerable improvement, even in high-income settings," Webster said. "Most hypertension guidelines in these countries do not recommend combination blood-pressure-lowering therapy for initial treatment in all people."

The findings, she said, "should prompt reconsideration of recommendations around the use of combination therapy."

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