January 13, 2017Cochrane libraryOpen Access

First-line combination therapy versus first-line monotherapy for primary hypertension

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Why the study?

Does first-line combination therapy improve clinical outcomes compared to first-line monotherapy in adults with primary hypertension?

Population

568 adults with primary hypertension initiating treatment, mostly European and white outpatients. Two trials…

Comparison

Combination of two first-line antihypertensive… vs Monotherapy as initial treatment

Design

Systematic_review, Randomized, Double-blind

Follow-up

12 to 36 months

Authors

JGJavier GarjónServicio Navarro de Salud LSLuis Carlos SaizServicio Navarro de Salud AAAna Azparren

Discussion

Member takes

Implication

Insufficient evidence guides initial monotherapy versus combination therapy in hypertension; leaves open whether either improves clinical outcomes.

Structured PICO

Does first-line combination therapy improve clinical outcomes compared to first-line monotherapy in adults with primary hypertension?

Population

568 adults with primary hypertension (systolic blood pressure/diastolic blood pressure ≥140/90 mmHg, or ≥130/80 mmHg if diabetes) initiating treatment, mostly European and white outpatients. Two trials included only type 2 diabetes patients.

Intervention

Combination of two first-line antihypertensive drugs as initial treatment

Comparator

Monotherapy as initial treatment

Outcome

Mortality, serious adverse events, cardiovascular events, and cardiovascular mortalityhard clinical

There is currently insufficient evidence from randomized trials to determine whether initiating hypertension treatment with combination therapy versus monotherapy improves clinical outcomes.

Limitations

Very low certainty of evidence due to serious imprecision
Small number of participants and events
Relied on subgroups not defined in advance

Cite This Study

Garjón et al. (2017) studied this question.

synapsesocial.com/papers/6a70fed86c240de38cdc0208 https://doi.org/10.1002/14651858.cd010316.pub2

Topics

Hypertension management Cardiovascular prevention

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Ask AI

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Implication

Insufficient evidence guides initial monotherapy versus combination therapy in hypertension; leaves open whether either improves clinical outcomes.

First-line combination therapy versus first-line monotherapy for primary hypertension

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

First-line combination therapy versus first-line monotherapy for primary hypertension

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider