Twin-drug pill may transform blood pressure treatment

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London: A single pill with two drugs could help better manage high blood pressure, say experts.
The 2018 European Society of Cardiology (ESC) and European Society of Hypertension (ESH) Guidelines on arterial hypertension recommend starting most patients on two blood pressure lowering drugs, not one.
Previous recommendation was for step-wise treatment, which meant starting with one drug then adding a second and third if needed.
This suffered from “physician inertia,” in which doctors were reluctant to change the initial strategy despite its lack of success. At least 80 per cent of patients should have been upgraded to two drugs, yet most remained on one drug.
It is now recognised that a major reason for poor rates of blood pressure control is that patients do not take their pills.
‘Massive improvement’
Non-adherence increases with the number of pills, so administering the two drugs (or three if needed) in a single tablet “could transform blood pressure control rates,” state the guidelines published in European Heart Journal. “The vast majority of patients with high blood pressure should start treatment with two drugs as a single pill. These pills are already available and should massively improve the success of treatment, with corresponding reductions in strokes, heart disease, and early deaths,” said Bryan Williams, ESC Chairperson of the Guidelines Task Force, from the University College London in the UK.
Over one billion people have hypertension (high blood pressure) worldwide. Around 30-45 per cent of adults are affected, rising to more than 60 per cent of people over 60 years of age.
High blood pressure is the leading global cause of premature death, accounting for almost ten million deaths in 2015, of which 4.9 million were due to ischaemic heart disease and 3.5 million were due to stroke.