Key result
Single-pill combination antihypertensives are superior to monotherapy, with Irbesartan/amlodipine ranking first for reducing systolic blood pressure (SUCRA 92.2%).
Why the study?
The study was conducted to evaluate the efficacy of single-pill combination antihypertensive drugs in patients with uncontrolled essential hypertension.
Do single-pill combination antihypertensive drugs improve blood pressure reduction and control rates compared to monotherapy in patients with uncontrolled essential hypertension?
Meta-Analysis (n=16,273)
Do single-pill combination antihypertensive drugs improve blood pressure reduction and control rates compared to monotherapy in patients with uncontrolled essential hypertension?
Single-pill combinations, particularly ARB/CCB combinations, are superior to monotherapy for achieving blood pressure control in patients with uncontrolled essential hypertension.
Answers are grounded in this paper and cite their sources.
SPCs outperform monotherapy for BP control in uncontrolled hypertension; confirms ARB/CCB combinations as top-ranked options.
This study aimed to evaluate the efficacy of single-pill combination (SPC) antihypertensive drugs in patients with uncontrolled essential hypertension. Through Searching Pubmed, EMBASE, the Cochrane Library, and Web of Science collected only randomized controlled trials on the efficacy of single-pill combination antihypertensive drugs in people with uncontrolled essential hypertension. The search period is from the establishment of the database to July 2022. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Assessment, and statistical analyses were performed using Review Manage 5.3 and Stata 15.1 software. This review ultimately included 32 references involving 16 273 patients with uncontrolled essential hypertension. The results of the network meta-analysis showed that a total of 11 single-pill combination antihypertensive drugs were included, namely: Amlodipine/valsartan, Telmisartan/amlodipine, Losartan/HCTZ, Candesartan/HCTZ, Amlodipine/benazepril, Telmisartan/HCTZ, Valsartan/HCTZ, Irbesartan/amlodipine, Amlodipine/losartan, Irbesartan/HCTZ, and Perindopril/amlodipine. According to SUCRA, Irbesartan/amlodipine may rank first in reducing systolic blood pressure (SUCRA: 92.2%); Amlodipine/losartan may rank first in reducing diastolic blood pressure (SUCRA: 95.1%); Telmisartan/amlodipine may rank first in blood pressure control rates (SUCRA: 83.5%); Amlodipine/losartan probably ranks first in diastolic response rate (SUCRA: 84.5%). Based on Ranking Plot of the Network, we can conclude that single-pill combination antihypertensive drugs are superior to monotherapy, and ARB/CCB combination has better advantages than other SPC in terms of systolic blood pressure, diastolic blood pressure, blood pressure control rate, and diastolic response rate. However, due to the small number of some drug studies, the lack of relevant studies has led to not being included in this study, which may impact the results, and readers should interpret the results with caution.
No takes yet. Share an insight, caveat, or question.
Xie et al. (2023) conducted a meta-analysis in uncontrolled essential hypertension (n=16,273). Single-pill combination antihypertensive drugs vs. Monotherapy was evaluated on Systolic blood pressure, diastolic blood pressure, blood pressure control rates, and diastolic response rate. Single-pill combination antihypertensives are superior to monotherapy, with Irbesartan/amlodipine ranking first for reducing systolic blood pressure (SUCRA 92.2%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: