1 May 2023 • According to a new meta-analysis, published online in JAMA Cardiology, for the initial treatment of hypertension polypills containing low doses of three or four antihypertensive agents are better at lowering blood pressure than monotherapy, usual care, or placebo and are generally well tolerated.

The current analysis included seven trials with a total of 1,918 patients (mean age 59 years; 38% women) who underwent initial hypertension treatment with a polypill containing three or four drugs, monotherapy, usual care, or placebo.

Patients who received polypills were more likely than those treated with monotherapy/usual care to have their BP controlled to below 140/90 mm Hg early on (66% vs 46%) and at 6-12 months (72% vs 59%). They were also more likely to be controlled compared with placebo-treated patients in the first 4 to 12 weeks (54% vs 18%).

The study is the latest by an Australian team that has long been investigating combo-pill approaches to improving hypertension management.

The only tolerability issue that arose was a higher rate of dizziness with the polypills versus active comparators (14% vs 11%)

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