Quadruple Single Pill Superior for Resistant Hypertension

WEDNESDAY, Sept. 11, 2024 (HealthDay News) -- For patients with resistant hypertension, a quadruple single pill is superior to triple therapy, according to a study presented at the European Society of Cardiology Congress, held from Aug. 30 to Sept. 2 in London.

Stefano Taddei, from the University of Pisa in Italy, and colleagues conducted a double-blind, randomized trial involving patients with resistant hypertension. Participants completed an eight-week run-in period during which they received the triple combination of perindopril, indapamide, and amlodipine. Those with uncontrolled blood pressure (BP) after eight weeks while adherent to therapy were randomly allocated to continue the same triple therapy or receive a single-pill combination containing perindopril, indapamide, amlodipine, and bisoprolol. A total of 183 patients from 49 centers in 13 countries were included in the trial.

The researchers found that the mean office sitting systolic BP was reduced by 20.67 and 11.32 mm Hg in the quadruple single-pill group and in the triple group, respectively, after eight weeks, with the adjusted difference significant in favor of the quadruple single pill. For the main secondary end point of mean 24-hour ambulatory systolic BP, there was a significant difference for the quadruple single pill versus the triple group (−7.53 mm Hg); in addition, there was a significant difference in favor of the quadruple single-pill group in mean office sitting diastolic BP (−6.14 mm Hg). BP control was achieved by 66.3 and 42.7 percent on the quadruple single pill and on triple therapy, respectively.

"The availability of a quadruple single-pill combination that includes bisoprolol could help with non-adherence and provide much-needed effective BP control in patients with resistant or difficult-to-treat hypertension," Taddei said in a statement.

Several authors disclosed ties to the pharmaceutical and medical device industry, including Servier, which funded the study.

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