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Blood pressure triple pill could help protect millions from heart attacks and strokes, trial finds

Cheap new medication would be most useful in low and middle income countries where only a third of people have high blood pressure under control

Alex Matthews-King
Health Correspondent
Tuesday 14 August 2018 16:15 BST
High blood pressure is a leading cause of death around the world and unchecked increases risk of stroke
High blood pressure is a leading cause of death around the world and unchecked increases risk of stroke (Getty)

A three-in-one pill which significantly improves control of high blood pressure could help millions of people lower their chances of stroke or heart attack, a major trial has found.

A study published by the Journal of the American Medical Association on Tuesday found that the new treatment enabled 27 per cent more people to bring their blood pressure down to acceptable levels.

High blood pressure is the leading cause of death and heart disease around the world and the international team say this drug could be a low cost way to help people in low and middle income countries where it’s needed most.

The drug combines three medications for high blood pressure (hypertension) at low doses and showed significant improvements over the current single-drug system.

“This study has global relevance,” said Professor Anushka Patel, from the George Institute, University of New South Wales, Australia who led the "Triple Pill vs Usual Care Management for Patients with Mild-to-Moderate Hypertension" (Triumph) trial.

“While the most pressing need, from the perspective of the global burden of disease, is low and middle income countries, it’s equally relevant in a country like Australia where we’re still achieving only 40 per cent to 50 per cent control rates for high blood pressure.”

The trial followed 700 patients in Sri Lanka with high blood pressure and randomly allocated patients to receive either their doctor’s choice of blood pressure medication or the triple pill.

This included the medications telmisartan, amlodipine and chlorthalidone at lower doses than they would be given on a single medication.

Six months in 70 per cent of patients given the triple pill had brought their blood pressure down to the target level, compared to 55 per cent of patients on their doctor's recommended medication.

While there were slightly higher rates of side effects reported on the triple pill, chiefly dizziness, there was no significant difference in the number of patients who withdrew from the medication.

The process also freed up doctor and patient time and lowered health system costs.

“Patients are brought back at frequent intervals to see if they are meeting their targets with multiple visits required to tailor their treatments and dosage,” said Dr Ruth Webster another of the authors. “This is not only time inefficient, it’s costly."

Dr Webster added that a billion people around the world are estimated to have high blood pressure and in the vast majority of cases it is poorly controlled. “Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke,” she said.

Researchers not involved with the study said that the Triumph team had shown the beneficial effects of this "promising new therapy" and it was likely to have better results than single-drug approaches.

However, the drugs alone wouldn't be enough to help the 2.5 billion people around the world with slightly elevated pressure, said Dr Mark Huffman, from the Department of Preventative Medicine at Northwestern University, and his colleagues claim.

"Moving from pharmacological treatment to other policies [which] include reformulation of food products to contain less sodium, taxation of alcoholic beverages, and price increases on tobacco products, remain central for reducing the burden of hypertension-related conditions," they added.

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