Key result
Switching to single-pill triple therapy with therapeutic drug monitoring lowers office SBP by ~23 mmHg.
Why the study?
Does single-pill triple fixed dose combination therapy with therapeutic drug monitoring reduce blood pressure in patients with treatment-resistant hypertension?
Does single-pill triple fixed dose combination therapy with therapeutic drug monitoring reduce blood pressure in patients with treatment-resistant hypertension?
Answers are grounded in this paper and cite their sources.
Switching to a single-pill triple fixed-dose combination with therapeutic drug monitoring significantly improved blood pressure control in a small pilot cohort of patients with treatment-resistant hypertension.
BACKGROUND: Single-pill fixed dose combination (FDC) therapies are widely used in the treatment of arterial hypertension. OBJECTIVE: This pilot study aimed to evaluate the effects of a FDC therapy combined with therapeutic drug monitoring (TDM) on blood pressure (BP) in patients with treatment resistant hypertension. METHOD: The study population included patients with suspected treatment-resistant hypertension during treatment with at least 3 antihypertensive drugs. We evaluated the effect of switching all patients to a regime including a single-pill triple FDC containing olmesartan, amlodipine and hydrochlorothiazide. Adherence was evaluated by measuring serum concentrations of amlodipine in a single-blinded fashion. RESULTS: We enrolled 13 patients (mean age 57.2±9.1 years, 8 males) with resistant hypertension (office systolic and diastolic BP 158.3±17.3 and 94.8±11.1 mmHg); mean use of antihypertensive drugs was 3.8±1.1. Medication intake of FDC was confirmed in all patients at 18 weeks. Systolic and diastolic office BP were significantly lower (-22.8 and -13.6 mmHg) after 18 weeks of treatment with triple FDC (135.5±20.1 and 81.2±6.3 mmHg, p<0.01, respectively); mean use of antihypertensive drugs was 3.8±0.9. In 9 patients with 24-h ambulatory BP monitoring (ABPM) both at baseline and after 18 weeks, 24-h mean arterial pressure decreased (-9.3 mmHg, p=0.055). Overall, 9 (69%) patients achieved BP control in office BP and 4 (31%) in 24-h ABPM. CONCLUSION: Our results support the use of single-pill triple FDC therapy in combination with TDM for the management of patients with suspected treatment-resistant hypertension and further testing in clinical studies.
No takes yet. Share an insight, caveat, or question.
Kreutz et al. (2017) studied treatment-resistant hypertension (n=13). Single-pill triple fixed dose combination (olmesartan, amlodipine, hydrochlorothiazide) with therapeutic drug monitoring vs. Baseline (pre-switch regimen) was evaluated on office systolic blood pressure (MD -22.8 mmHg, p=<0.01). Switching to a single-pill triple fixed-dose combination with therapeutic drug monitoring significantly reduced office systolic blood pressure by 22.8 mmHg (p<0.01) at 18 weeks.
Synapse has enriched 10 related papers. Consider them for comparative context: