Key result
Ultra-low dose quadpill reduces systolic BP by ~7 mmHg vs monotherapy similarly across sexes.
Why the study?
Women with hypertension are more likely than men to have ineffective treatment where blood pressure is treated but not controlled, motivating investigation of sex differences in response to quadpill therapy.
Does an ultra-low dose combination therapy (quadpill) reduce blood pressure differently between males and females with hypertension compared to monotherapy?
RCT (n=591)
randomized
Does an ultra-low dose combination therapy (quadpill) reduce blood pressure differently between males and females with hypertension compared to monotherapy?
Effect estimate: MD -6.34 (females), MD -6.95 (males) (95% CI -9.50 to -3.18 (females), -9.53 to -4.38 (males))
p-value: p=0.77
Initial treatment with an ultra-low dose quadruple combination pill is similarly effective in lowering blood pressure in both men and women with hypertension.
Quadpill yields similar BP reductions by sex; extends primary QUARTET findings by confirming no treatment-sex interaction.
Women with hypertension are more likely than men to have ineffective treatment where blood pressure (BP) is treated but not controlled. The aim of this study was to investigate whether a quadpill based strategy differs between males and females. A secondary analysis of The Quadruple UltrA-low-dose tReaTment for hypErTension (QUARTET); randomized controlled trial. In this analysis the primary outcome was sex differences in unattended office systolic BP at 12 weeks. The QUARTET study recruited 591 participants (40% female) with mean age 59 (standard deviation 12) years [male 57 (12); female 62 (11)]. Males and females recorded a similar reduction in unattended systolic BP at 12 weeks with no interaction between group allocation and sex [male:mean difference (MD) in mmHg -6.95 (95% CI -9.53 to -4.38), female: MD -6.34 (95% CI -9.50 to -3.18), interaction P = 0.77]. The quadpill strategy was similarly effective in men and women. Initiating BP control with a quadpill in women presents a promising approach to achieving similar BP control levels to men.
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O’Hagan et al. (2025) conducted an RCT in hypertension (n=591). ultra-low dose combination therapy (quadpill) vs. monotherapy was evaluated on sex differences in unattended office systolic BP at 12 weeks (MD -6.34 (females), MD -6.95 (males), 95% CI -9.50 to -3.18 (females), -9.53 to -4.38 (males), p=0.77). An ultra-low dose quadpill strategy reduced unattended systolic blood pressure similarly in men (MD -6.95 mmHg) and women (MD -6.34 mmHg) at 12 weeks (interaction P = 0.77).
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