Triple low-dose combination therapy significantly reduced systolic blood pressure by 13.76 mmHg compared with placebo (95% CI, -19.28 to -8.23) and more than doubled blood pressure control rates.
Meta-Analysis (n=1,749)
Does single-pill triple low-dose combination therapy reduce blood pressure compared with placebo or standard-dose monotherapy in patients with hypertension?
Initial low-dose triple combination therapy provides substantial blood pressure reduction compared with placebo and modest additional benefit over standard-dose monotherapy without increasing adverse events.
Mean Difference: -13.76 (95% CI -19.28–-8.23)
Objective: Single-pill triple low-dose combination (triple-LDC) antihypertensive drugs have become available for clinical use as an alternative initial therapy for hypertension, expanding options beyond conventional monotherapy. We evaluated the efficacy and safety of triple-LDC therapy compared with placebo or standard-dose (SD) monotherapy. Design and method: This systematic review and meta-analysis followed a prespecified PROSPERO-registered protocol and PRISMA guidelines. Randomized controlled trials comparing triple-LDC therapy (1.0 SD) and ultra-low-dose (sum of dose fraction <=1.0 SD) regimens were superior to placebo, with no differences between doses. Versus SD monotherapy, low-dose therapy was superior, whereas ultra-low-dose therapy showed comparable efficacy. Findings were consistent in sensitivity analyses. Treatment-emergent adverse events and withdrawal rates were similar across groups.Conclusions: Triple-LDC therapy provides substantial BP reduction compared with placebo and modest additional benefit over SD monotherapy without increased adverse events, supporting its role as an effective initial treatment strategy for hypertension.
Rhee et al. (Fri,) conducted a meta-analysis in hypertension (n=1,749). Triple low-dose combination (triple-LDC) therapy vs. Placebo or standard-dose monotherapy was evaluated on systolic blood pressure reduction compared with placebo (MD -13.76, 95% CI -19.28 to -8.23). Triple low-dose combination therapy significantly reduced systolic blood pressure by 13.76 mmHg compared with placebo (95% CI, -19.28 to -8.23) and more than doubled blood pressure control rates.