Combining 3 blood pressure drugs into one pill is 20% more effective

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Combining three blood pressure drugs into a single pill is 20% more effective

Combining three blood pressure drugs into a single pill is 20% more effective at slashing deadly hypertension that causes heart attacks, concludes trial

  • At the moment only 50% of those on blood pressure drugs get to healthy levels
  • But using a combination therapy saw the success rate rise to 70% in 6 months
  • The results could offer a new approach for the hundreds of thousands of people 
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Combining three blood pressure drugs into a single pill could be far more effective than existing treatments, a trial has shown.

At the moment only half of people on blood pressure medication manage to get their levels down to a healthy target.

But using a triple combination therapy saw the success rate rise to 70 per cent within six months.

The results could offer a new approach for the hundreds of thousands of people in the UK take daily tablets for their blood pressure.

Dr Ruth Webster, of the George Institute for Global Health in Australia, said: ‘Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke.’


At the moment only half of people on blood pressure medication manage to get their levels down to a healthy target. But using a triple combination therapy saw the success rate rise to 70 per cent within six months

Her team, based at the University of New South Wales, found combining three existing treatments at half the normal dose was not only effective, but was as safe as giving drugs separately.

Traditionally patients begin treatment with one drug at a low dose, which is increased over time with additional drugs added and increased in dosage to try to push down blood pressure.

That involves a lot of trial and error and lots of repeat appointments – and many patients just give up on the pills.

Dr Webster said: ‘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.

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‘This is not only time inefficient, it’s costly. We also know that many doctors and patients find it too complicated and often don’t stick to the process. This new approach is much simpler and it works.’

High blood pressure – known by the medical name of ‘hypertension’ – affects one in three adults, more than 17 million of the British population and 75 million in the US.

The condition vastly increases the risk of heart attacks, strokes and vascular dementia, but because it has no symptoms until it is too late, only half of people even know they are at risk.

Of those who have been diagnosed, hundreds of thousands take daily pills to control their blood pressure.

But the pills – which at the moment contains just one drug in each tablet – only successfully reduce pressure to a healthy level in half of patients.

The new approach could see that transformed.

It is particularly timely because NHS watchdog NICE is currently reviewing blood pressure guidelines with a view to cutting rates of heart disease.

They are considering lowering the threshold for prescribing blood pressure medication, which could mean millions more Britons are offered drugs.

The trial, which was conducted in Sri Lanka, involved 700 patients with an average age of 56 and blood pressure of 154/90.

Half of patients were given the ‘triple pill’ – which consisted of common blood pressure medications telmisartan, amlodipine and chlorthalidone.

The other half were given a single medication of their doctor’s choice.

Some 70 per cent of patients on the triple pill reached their target blood pressure of 140/90 – and on average they went far lower, achieving a reading of 125/76 after six months.

Of those on normal treatments, in comparison, only 55 per cent reached the target and the average level after six months was just 134/81.

Professor Anushka Patel, principal Investigator of the trial and chief scientist at the George Institute, said this was big improvement.

‘The World Heart Federation has set an ambitious goal that by 2025 there will be a 25 per cent reduction in blood pressure levels globally,’ she said.

‘The triple pill could be a low cost way of helping countries around the world to meet this target.’ 

Before that happens, however, it would have to be assessed by health authorities around the world – including the UK – to ensure the combination was as safe as the researchers believe.

The study was published in the JAMA medical journal. 

WHAT DOES IT MEAN IF I HAVE HIGH BLOOD PRESSURE?

High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

More than one in four adults in the UK have high blood pressure, although many won’t realise it.

The only way to find out if your blood pressure is high is to have your blood pressure checked.

Blood pressure is recorded with two numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body.

The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels. They’re both measured in millimetres of mercury (mmHg).

As a general guide:

  • high blood pressure is considered to be 140/90mmHg or higher
  • ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
  • low blood pressure is considered to be 90/60mmHg or lower
  • A blood pressure reading between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you don’t take steps to keep your blood pressure under control.

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening conditions, such as:

  • heart disease
  • heart attacks
  • strokes
  • heart failure
  • peripheral arterial disease
  • aortic aneurysms
  • kidney disease
  • vascular dementia

Source: NHS

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