Single pill combination therapy for hypertension was projected to reduce mortality by 5.4%, clinical events by 11.5%, and DALYs by 5.7% versus current treatment practices over 10 years.
Does single pill combination therapy improve 10-year clinical outcomes compared to other treatment pathways in patients with hypertension?
Microsimulation modeling suggests that single pill combination therapy for hypertension could significantly reduce mortality and clinical events over 10 years compared to conventional management, primarily driven by improved adherence.
INTRODUCTION: Hypertension affects almost a third of the Italian population and is a major risk factor for cardiovascular disease. Management of hypertension is often hindered by poor adherence to complex treatment regimens. This analysis aimed to estimate the 10-year clinical outcomes associated with single pill combination (SPC) therapies compared with other treatment pathways for the management of hypertension in Italy. METHODS: A microsimulation modeling approach was used to project health outcomes over a 10-year period for people with hypertension. Input data for four treatment pathways current treatment practices (CTP), single drug with dosage titration then sequential addition of other agents (start low and go slow, SLGS), free choice combination with multiple pills (FCC) and SPC were sourced from the Global Burden of Disease 2017 data set. The model simulated clinical outcomes for 1 000 000 individuals in each treatment pathway, including mortality, chronic kidney disease (CKD), stroke, ischemic heart disease (IHD) and disability-adjusted life years (DALYs). RESULTS: Through improved adherence, SPC was projected to improve clinical outcomes versus CTP, SLGS, and FCC. SPC was associated with reductions in mortality, incidence of clinical events, and DALYs versus CTP of 5.4%, 11.5%, and 5.7%, respectively. SLGS and FCC were associated with improvements in clinical outcomes versus CTP, but smaller improvements than those associated with SPC. CONCLUSIONS: Over 10 years, combination therapies (including SPC and FCC) were projected to reduce the burden of hypertension compared with conventional management approaches in Italy. Due to higher adherence, SPC was associated with the greatest overall benefits versus other regimens.
Borghi et al. (Mon,) conducted a other in Hypertension (n=4,000,000). Single pill combination (SPC) therapy vs. Current treatment practices (CTP), start low and go slow (SLGS), and free choice combination (FCC) was evaluated on Mortality, chronic kidney disease, stroke, ischemic heart disease, and disability-adjusted life years. Single pill combination therapy for hypertension was projected to reduce mortality by 5.4%, clinical events by 11.5%, and DALYs by 5.7% versus current treatment practices over 10 years.
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