Several Antihypertensive Meds at Smaller Doses Better for Blood Pressure

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Combining quarter doses of two drugs was as effective as a single standard dose of one blood pressure-lowering medication.
Combining quarter doses of two drugs was as effective as a single standard dose of one blood pressure-lowering medication.

(HealthDay News) — Combining low doses of several different antihypertensive medications may be better than using a standard dose of just one drug, according to a review published online in Hypertension.

Anthony Rodgers, MD, PhD, a professor of global health at the George Institute for Global Health and University of New South Wales in Sydney, and colleagues reviewed 42 studies involving ultra-low doses of multiple medications.

According to the researchers, combining quarter doses of two drugs was as effective as a single standard dose of one blood pressure-lowering medication. A combination of four medications — each at one-quarter dose — was nearly twice as effective as one drug at the standard dose, they found. In general, all of the quarter-dose combinations reduced systolic and diastolic blood pressure by several points compared to a placebo. One study of quarter doses of four medications combined found that the combination reduced systolic blood pressure by 22.4 points and diastolic by 13.1 points, on average, compared to a placebo, the researchers reported.

"In terms of adverse events, single and dual quarter-dose therapy was not significantly different from placebo and had significantly fewer adverse events compared with standard-dose monotherapy," the authors write. "Quarter-dose combinations could provide improvements in efficacy and tolerability of blood pressure-lowering therapy."

Several authors disclosed financial ties to the pharmaceutical industry; two authors are named on pending patents related to the research.

Reference

  1. Bennett A, Chow CK, Chou M, et al. Efficacy and Safety of Quarter-Dose Blood Pressure-Lowering Agents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Hypertension. 5 June 2017. doi: 10.1161/HYPERTENSIONAHA.117.09202

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