Antihypertensive Medicine Combination Treatment is Better than Monotherapy for Lowering Blood Pressure, Study Reveals

A recent study has revealed that combination treatment with three or more hypertensive medicines provides greater blood pressure lowering effect than monotherapy. Although, the net benefit may be lessened when considering side effects.

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Researchers investigated electronic databases for BP-lowering randomized controlled trials (RCTs) comparing combination treatment or monotherapy with placebo, no treatment, or less-complex treatment.

The combination treatment was considered when background treatment continued during follow-up on top of the trial medicines of interest and medicines were added to the initial drugs of interest in most patients. Monotherapy, on the other hand, was considered when pre-randomization treatment was withdrawn or absent and a single drug was administered at random.

Notably, complexity of treatment refers to the higher averaged number of daily medications used in the eligible RCTs.

There were 93 trials including 290,304 patients with follow-up period of 3.9 years were included in the analysis. On-treatment average number of drugs was 2.10 in the more actively treated patients and 0.99 in the less actively treated group.

The combination treatments of any complexity compared with placebo, no treatment, or less-complex treatment resulted in a reduction of all or most fatal and non-fatal outcomes.

On the other hand, there was an increased rate of side effects that led to treatment discontinuation was observed during the study, but in absolute numbers the benefit outweighed the harm.

Researchers said that use of drug combinations is recommended by hypertension guidelines for most patients because of the greater BP-lowering effect compared with monotherapy.


Source: J Hypertension 2021


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