A Combination Low-Dose Pill to Control Hypertension?

Amid discussions of lower targets for blood pressure (BP), too many people still respond inadequately to antihypertensive medications. One strategy, combining lower doses of several generic, low-cost medications, may be particularly attractive for compliance — and might even reduce risk at modest cost. In an open-label, pragmatic trial, investigators randomized 700 people in Sri Lanka with elevated BP (systolic BP, >140 mm Hg or diastolic BP, >90 mm Hg; patients with diabetes or chronic kidney disease >130 mm Hg systolic or >80 mm Hg diastolic) to a single triple-combination pill using fixed low-dose antihypertensive medications or to usual care (mean age, 56; women, 58%; diabetes, 29%).

Triple therapy involved 20 mg telmisartan, 2.5 mg amlo…