Combination pill reduces hypertension death by 14%

A new study published in PLOS Medicine suggests people prescribed a single-pill fixed-dose drug combination (FDC) to manage hypertension are more likely to be compliant with their medication and achieve better health outcomes than those taking separate pills.

“We found that people who received single-pill combinations had a significantly lower rate of the combined outcome of death or hospitalization for heart attack, heart failure, or stroke and that these differences were related to better medication adherence,” wrote lead author Amol A. Verma, MD, of St. Michael’s Hospital in Toronto, and colleagues.

About 75 percent of individuals exhibiting hypertension require more than one medication for blood pressure control and many are prescribed multiple pulls rather than a combination pill.

The researchers examined how FDC and multi-pill therapies impacted cardiovascular-related events or death.

“Addressing this question in a real-world setting is particularly important because the differences between FDC and multi-pill therapy arise from the way medications are used, and patterns of medication use in clinical trials may not be generalizable,” Verma wrote.

The researchers utilized the health data of 13,350 people from the Institute for Clinical Evaluative Sciences who were prescribed at least two medications for hypertension. The cohort was followed for an average of four years.

Among people who took multiple pills, 1,008 cardiovascular-related events occurred, compared to 904 events who took a combination pill—translating to a 14 percent reduction in deaths for individuals taking the combination pill.

“Using single-pill combinations rather than multiple pills may represent a simple and potentially low-cost intervention that could substantially reduce the global burden of death and disability related to hypertension,” Verma wrote.

The researchers noted the main limitations of this study were the lack of data regarding cause of death and blood pressure measurements and the possibility of residual confounding.