Four in one antihypertensive drugs can improve the prognosis

A new clinical trial from Australia shows that the four in one pill contains “ultra-low doses” of different drugs, which can better control blood pressure than standard drug treatment.
The researchers reported that about 80% of people taking “Siyuan pill” reached a healthy blood pressure of 140 / 90 within three months and lasted for one year, while 60% began to take a single drug and supplement other drugs as needed.
Dr Clara Chow, a medical professor at the University of Sydney, said: “at first, this combination of low-dose blood pressure drugs is more effective than one dose of common drugs, and then gradually add drugs to improve blood pressure control.”
“Even at 12 months, there was no catch-up – that is, the group that started taking the four in one pill still had better blood pressure control at 12 months,” Zhou continued.
Dr. Eugene young, director of cardiovascular disease prevention at the American College of Cardiology, said that some blood pressure treatment guidelines have recommended the use of different drug combinations to better achieve a healthy level.
Combining these different drugs into one pill can help people better adhere to treatment, said Yang, medical director of the East professional center of medicine at Washington University in Bellevue.
“Many factors driving this strategy are improving compliance, because we know that the more pills you take, the lower compliance,” Yang said.
Four different tested antihypertensive drugs were combined into one tablet and randomly prescribed to half of nearly 600 Australians to test their safety and effectiveness.
Chow and her colleagues believe that since each drug contained in the pill is equivalent to a quarter of the normal prescription, the possibility of side effects will be less.
“The quarter dose of each antihypertensive drug is not the effective quarter. In fact, its effective rate is closer to 60%,” Zhou explained. “The four drugs included here reduce blood pressure in different ways; In other words, they are synergistic. Therefore, when used in combination, a quarter dose of the drug has the greatest effect on the smallest dose of the drug. “
Their suspicions were correct because the group taking Siyuan pills had few serious side effects.
“The side effects of any ultra-low dose of these drugs are very small. Side effects are almost always dose-related, and these are ultra-low doses, “said Dr. Robert Carey, honorary Dean of the University of Virginia School of medicine and co-author of the American Heart Association’s blood pressure treatment guidelines.
After three weeks, the average blood pressure of Siyuan pill group was 120 / 71, while that of standard nursing group was 127 / 79.
The findings were published in the August 29 issue of the lancet and at the European Society of Cardiology meeting last week.
Carey says such a four yuan pill is most beneficial to developing countries and remote areas of the United States, where there are few health care opportunities.
In such places, “your ability to measure blood pressure at home or in the office will be weakened, as will your ability to increase and titrate drug doses,” Carey explained.
The main obstacle at present is that “there are no large-scale manufacturers to manufacture this low-dose quadruple combination, although we hope they can consider this through research evidence,” Chow said. The combination of early low-dose antihypertensive drugs is a more effective method, which can quickly, safely and effectively control blood pressure, and the total dose of drugs is the lowest. “
Although he found the results promising, Yang said he would like to see a longer clinical trial to treat patients with hypertension. He pointed out that the average blood pressure of the trial participants at the beginning was 141 / 85, and the study was designed to help people achieve a blood pressure below 140 / 90.
“They didn’t start from a starting point where they needed to do a lot of things to achieve this goal,” Yang said.
He also hopes that future research will include whether four pills can lower blood pressure and help people avoid life-threatening diseases.
“What you really want to know is whether these interventions can bring some meaningful benefits, such as reducing heart attack, stroke or heart failure,” Yang said.