Single, fixed-dose combo pills improve hypertension outcomes

Single-pill, fixed-dose combination (FDC) treatment may be more effective for improving blood pressure control in older patients, according to a study recently published in PLOS Medicine.

16 sept 2018--Amol A. Verma, M.D., from St. Michael's Hospital in Toronto, and colleagues used linked clinical and administrative databases to compare clinical outcomes and medication adherence for patients prescribed one angiotensin-converting enzyme inhibitor or angiotensin II-receptor blocker plus one thiazide diuretic, either as a single-pill FDC or as a multi-pill combination. The authors performed a retrospective cohort study, with five year follow-up, of 13,350 patients aged 66 years or older.

The researchers observed no significant difference in outcomes between groups while patients were on treatment (hazard ratio, 1.06; 95 percent confidence interval, 0.86 to 1.31; P = 0.60). The proportion of total follow-up days covered with medications was significantly greater in the FDC group (70 percent) versus the multi-pill group (42 percent; P < 0.01), and a composite of death or hospitalization for acute myocardial infarction, heart failure, or stroke was less frequent in FDC recipients (3.4 versus 3.9 events per 100 person-years; hazard ratio, 0.89; 95 percent confidence interval, 0.81 to 0.97; P < 0.01).
"Among older adults initiating combination antihypertensive treatment, FDC therapy was associated with a significantly lower risk of composite clinical outcomes, which may be related to better medication adherence," the authors write.
One author disclosed financial ties to the pharmaceutical industry.

More information: Abstract/Full Text