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Combo of Several Meds at Smaller Doses May Boost HTN Care

TUESDAY, June 6, 2017 -- 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 June 5 in Hypertension.

Anthony Rodgers, M.D., Ph.D., 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.

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Posted: June 2017