Details

Autor(en) / Beteiligte

• Kahan, Thomas

Titel

Low-dose combination of blood pressure-lowering medicines

Ist Teil von

• The Lancet (British edition), 2021-09, Vol.398 (10305), p.1022-1023

Ort / Verlag

London: Elsevier Ltd

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Most of the effect on blood pressure reduction and the lowest risk for side-effects is achieved with low doses for most antihypertensive drug classes, suggesting that starting treatment with a combination of blood pressure-lowering medicines at low doses might improve blood pressure control.4 In The Lancet, Clara Chow and colleagues5 report the results of a randomised, controlled, parallel-group, multicentre, phase 3 study in Australia comprising 591 people with hypertension. The Good Brigade/Getty Images Most patients with hypertension will require two or more medicines to achieve the current recommended target blood pressure.6 Previous studies have shown that initiation of antihypertensive treatment with two or more medicines, as compared with monotherapy, improves drug and treatment adherence and persistence, reduces care provider inertia, improves blood pressure control, and reduces cardiovascular events; and single-pill combinations appear to offer additional advantage.7–11 Accordingly, current guidelines recommend initiating antihypertensive therapy with two medicines in most patients.12,13 The study by Chow and colleauges5 extends these findings by showing that a single-pill, low-dose combination will achieve target blood pressure quicker and maintain blood pressure control more effectively than the prevailing practice to start with a single medicine, without major impairment of safety or tolerability. Antihypertensive drug classes might have different effects on cardiovascular pathophysiology beyond the effects of blood pressure reduction, with possible prognostic implications. [...]we look forward to subsequent studies to show the transition of blood pressure reduction with single-pill, low-dose combinations to a superior reduction in cardiovascular events.