Combining pills may simplify treatment and reduce stroke risk, study suggests
Combining blood pressure drugs into a single pill may cut stroke risk and help patients reach targets sooner, a new scientific statement suggests.
The statement says single-pill combinations could simplify treatment and help more adults with high blood pressure reach and maintain goals compared with taking multiple separate pills daily.
High blood pressure, also known as hypertension, is a leading cause of stroke, heart attack, heart failure, kidney disease, cognitive decline and dementia.
The scientific statement was published by the American Heart Association and details the latest clinical evidence on using combination medicines for patients with high blood pressure.
Jordan B. King is chair of the statement writing group and an associate professor of population health sciences at the University of Utah.
He said: “Most people with high blood pressure need two or more blood pressure medications to reach target blood pressure measurements; however, taking multiple pills each day can be confusing or hard to keep up with.
“Single-pill combination pills are valuable tools to manage high blood pressure. Individuals taking a single combination pill are able to achieve optimal blood pressure levels sooner than peers who take the same medications in separate pills.”
Observational studies with follow-up periods of one to five years have linked single-pill combination use with a 15 to 30 per cent lower risk of major adverse cardiovascular events, including heart attack, stroke, heart failure-related hospitalisations and death.
The statement notes that less than 50 per cent of US adults being treated for high blood pressure achieve the recommended goal of below 130/80 mm Hg.
King added: “If single-pill combinations were the norm rather than the exception, there could be a meaningful improvement in blood pressure control across the population, which could significantly reduce the risk of heart attacks and strokes.
“In the long run, better blood pressure control lowers health care costs for patients and society, enhances quality of life and improves health outcomes for the millions of people with high blood pressure.”
However, barriers remain.
These include limited clinician awareness of available combination therapies, concerns about reduced flexibility in adjusting dosages, and insurance restrictions that may result in higher out-of-pocket costs for patients.
The authors call for more research on the safety and effectiveness of combination pills for higher-risk groups, including people with resistant hypertension (hard-to-treat high blood pressure), chronic kidney disease, diabetes or heart failure.
