Antihypertensive Monotherapy: Time to Rethink Our Approach?

Current guidelines from the American Heart Association and American College of Cardiology recommend initiating fixed-dose combination therapy for patients with stage 2 hypertension (>140/90 mm Hg), given previously reported low rates of blood pressure control with monotherapy. But how often is monotherapy still used in real-world practice? To shed light on this question, researchers in Brazil analyzed 70,000 adults with hypertension across three cohorts. In the largest cohort, 63,000 patients recruited through multiple health centers underwent one-time in-office and at-home BP testing using standardized protocols. In the two smaller cohorts, patients with hypertension had two different BP measurements over time.