Triple Combination Therapy Use for Lowering Blood Pressure

A triple drug combination can significantly reduce blood pressure (BP) among individuals with hypertension compared with usual care, according to results of a new study.

Results were presented at the American College of Cardiology 18 Scientific Sessions this morning.

To examine whether initial treatment with a low-dose triple therapy would safely achieve BP targets, the researchers conducted the Triple Pill vs Usual Care Management for Patients With Mild-Moderate Hypertension study in Sri Lanka.

Overall, 700 adults with hypertension that required initiation or up-titration of medication were included in the study.

Participants were randomly assigned to a fixed-dose combination of telmisartan, 20mg, amlodipine, 2.5mg, and chlorthalidone, 12.5mg (Triple Pill group), or a usual care group.

The researchers defined the primary outcome as a BP at or below 140/90 mmHg, or at or below 130/80 mmHg in patients with diabetes or chronic kidney disease.

At 6 months, 83% of participants in the Triple Pill group were still receiving all 3 study drugs.

The Triple Pill regimen had helped participants achieve the primary outcome at 6 months compared with usual care (70% vs 55%). The greatest difference was seen at 6 weeks of treatment (68% vs 44%).

In addition, adverse events were similar between the groups (38.7% vs 34.7%).

“Initial use of low-dose triple combination therapy is a safe and highly effective strategy to rapidly achieve BP control,” the researchers concluded.

—Amanda Balbi

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